[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1640 Introduced in House (IH)]

103d CONGRESS
  1st Session
                                H. R. 1640

 To provide for the immunization of all children in the United States 
     against vaccine preventable diseases, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 1, 1993

Mr. Waxman (for himself, Mr. Dingell, Ms. Slaughter, Mrs. Clayton, Mr. 
 Synar, Mr. Richardson, Mr. Rowland, Mr. Slattery, Mr. Washington, Mr. 
Brown of Ohio, Mr. Kreidler, Ms. Pelosi, Mr. McDermott, and Mr. Wyden) 
   introduced the following bill; which was referred jointly to the 
          Committees on Energy and Commerce and Ways and Means

                              May 13, 1993

 Additional sponsors: Mr. Klein, Mr. Studds, Mr. Swift, and Mr. Rangel

                            October 21, 1993

     Additional sponsors: Mr. Gutierrez, Mr. Berman, and Mr. Bishop

_______________________________________________________________________

                                 A BILL


 
 To provide for the immunization of all children in the United States 
     against vaccine preventable diseases, 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 AND REFERENCES IN THE ACT.

    (a) Short title.--This Act may be cited as the ``Comprehensive 
Child Immunization Act of 1993''.
    (b) References in Act.--The amendments in this Act apply to the 
Public Health Service Act unless otherwise specifically stated.

SEC. 2. PURPOSE OF THE ACT.

    The purpose of this Act is to ensure that all children in the 
United States are protected against vaccine preventable infectious 
diseases at the earliest appropriate age; to establish a program to 
purchase vaccines and to distribute them to all willing health care 
providers; to establish a tracking program to monitor which children 
need to be immunized and the results of immunizing children; and to 
extend the National Childhood Vaccine Injury Compensation Program.

SEC. 3. FINDINGS OF THE CONGRESS.

    (a) Current Circumstances.--The Congress makes the following 
findings as to current circumstances:
            (1) Immunizations are among the most cost-effective means 
        of preventing disease.
            (2) Although Federal support for childhood immunizations 
        has been in existence since 1962, the full potential of 
        immunizations remains to be achieved. Enactment and enforcement 
        of school immunization requirements have resulted in excellent 
        immunization levels (96 percent or greater) in school children. 
        However, approximately 80 percent of vaccine doses should be 
        received before the second birthday in order to protect 
        children during their most vulnerable periods. Many children do 
        not receive their basic immunizations by that time, and in some 
        inner cities as few as 10 percent of 2-year olds have received 
        a complete series. This low level of immunizations has been 
        reflected in recent years by outbreaks of measles among 
        inadequately immunized pre-school children.
            (3) The ``infrastructure'' to immunize children is both 
        public and private. There is considerable evidence to suggest 
        that the ``private'' infrastructure has been damaged over the 
        past decade as a result of the significantly increased cost of 
        privately purchased vaccine.
            (4) In some cases costs have risen over a ten-year period 
        by nearly 1400 percent, with private rates exceeding the rates 
        paid for like vaccines in some other industrialized nations by 
        over 2500 percent.
            (5) High costs, coupled with the growing number of 
        uninsured and underinsured families, mean that private 
        physicians are increasingly referring their private patients to 
        overburdened public clinics for vaccinations.
            (6) Eleven States now have programs that provide vaccines 
        without charge to both public and private health care 
        providers. Some of these programs have been in place for more 
        than 20 years, with virtually no burden or controversy. Other 
        States that have sought to establish such programs have been 
        denied additional discounted vaccines by manufacturers.
            (7) There is no evidence to suggest that a negotiated price 
        that takes into account the reasonable cost of production, 
        marketing, research and development, and distribution will not 
        fairly compensate vaccine manufacturers. Indeed, a recent 
        report by the Congressional Office of Technology Assessment 
        supports the proposition that negotiated rates can assure fair 
        compensation while holding down costs.
            (8) The Secretary of Health and Human Services has 
        experience negotiating vaccine purchase through the Federal 
        contract system.
            (9) The National Vaccine Injury Compensation Program is an 
        essential element in a comprehensive immunization program and 
        should be strengthened and applied to additional vaccines 
        recommended for universal use in children.
    (b) Needed Actions.--The Congress makes the following findings as 
to actions needed to ensure the full immunization of children at the 
earliest appropriate age:
            (1) The Federal Government should purchase and provide free 
        of charge to health care providers vaccines recommended for 
        universal use in children. This action will not only remove 
        financial barriers to immunization that impede children from 
        being vaccinated at the appropriate time, but will also 
        facilitate development of an immunization tracking system.
            (2) The Federal Government and the States should develop 
        linked registries to track the immunization status of the 
        Nation's children. The registries should have the capability to 
        notify parents of inadequately immunized children of the need 
        to protect their children with specific vaccines.
            (2) The coordinated national information and education 
        outreach initiative inaugurated by the Department of Health and 
        Human Services in 1993 should be continued. This program brings 
        needed information to parents and health care providers and 
        focuses their attention on the importance of achieving the full 
        immunization of children at the earliest appropriate age.
            (4) Private and public health insurers should be encouraged 
        to provide adequate reimbursement for the administration of 
        childhood vaccines.
            (5) Volunteer community activities to promote the full 
        immunization of children at the earliest appropriate age should 
        be encouraged.
            (6) The National Vaccine Injury Compensation Program should 
        be extended and improved. Vaccine information materials should 
        be simplified to ensure that parents can understand the 
        benefits and risks of vaccines.

SEC. 4. FEDERAL PURCHASE AND TRACKING OF CHILDHOOD VACCINES.

    (a) In General.--Title XXI of the Public Health Service Act is 
amended by adding at the end a new Subtitle 3 as follows:

   ``Subtitle 3--Federal Purchase and Tracking of Childhood Vaccines.

``SEC. 2141. PURCHASE BY THE SECRETARY.

    ``(a) Recommended Childhood Vaccines.--The Secretary shall 
promulgate not later than October 1, 1994 (and periodically thereafter 
as the Secretary determines appropriate in view of advances in 
scientific understanding in the areas of immunization and disease 
control), a list of vaccines that provide immunization against 
naturally occurring infectious diseases and are recommended for 
universal use in children. The Secretary shall concurrently promulgate 
recommendations regarding the appropriate dosage for each vaccine and 
the age or ages of children at which each vaccine should be 
administered.
    ``(b) Consultation.--The Secretary shall, in order to determine the 
amounts of vaccines to be purchased under subsection (c), consult with 
Federal agencies involved in research regarding, or the regulation, 
procurement, or distribution of, recommended childhood vaccines. The 
consultation may be effected through the establishment of a Vaccine 
Requirements Panel, composed entirely of representatives of the 
relevant Federal agencies, or through such other means as the Secretary 
finds appropriate.
    ``(c) Purchase of Vaccine.--
            ``(1) In general.--The Secretary shall periodically 
        purchase recommended childhood vaccines in amounts necessary 
        for--
                    ``(A) distribution under section 2142 to meet 
                anticipated needs for the routine and catch-up 
                immunization of children in the United States in 
                accordance with the recommendations promulgated under 
                subsection (a) and foreseeable outbreak control 
                activities, and
                    ``(B) maintenance of a reserve supply sufficient 
                for a six-month period.
        The Secretary shall negotiate a reasonable price for such 
        vaccine that takes fairly into account the various costs 
        described in paragraph (3).
            ``(2) Pre-procurement consultations.--The Secretary may 
        consult with representatives of State governments, experts in 
        vaccine delivery, health care providers, and others with 
        expertise in purchasing and pricing pharmaceutical products 
        prior to soliciting bids or offers for recommended childhood 
        vaccines under this subtitle.
            ``(3) Cost or pricing data.--A manufacturer of recommended 
        childhood vaccine shall provide cost or pricing data in support 
        of its proposed price at the time it responds to a procurement 
        instituted by the Secretary under this section. A manufacturer 
        shall also provide such data upon the request of the Secretary 
        whenever the Secretary determines that contract modifications 
        are necessary. This information shall include data related to 
        the research and development costs of the vaccine, production 
        costs, handling, shipping, and other costs associated with 
        delivering vaccine to health care providers and States in 
        accordance with the distribution plan of the Secretary (or a 
        State, as the case may be) under section 2142, marketing costs, 
        profit levels sufficient to encourage future investments in 
        research and development of new or improved vaccines, the cost 
        of maintaining adequate capacity for outbreak control, and any 
        other data the Secretary determines are relevant.
            ``(4)(A) Confidentiality of data.--Information provided to 
        the Secretary under paragraph (3) shall be treated as trade 
        secret or confidential information subject to section 552(b)(4) 
        of title 5, United States Code and section 1905 of title 18, 
        United States Code and shall not be revealed to any person 
        other than those authorized by the Secretary in connection with 
        carrying out official duties under this section.
            ``(B) Subparagraph (A) does not authorize the withholding 
        of information provided under paragraph (3) from any duly 
        authorized subcommittee or committee of the Congress. If the 
        Secretary provides such information to any subcommittee or 
        committee, the Secretary shall give written notice of this fact 
        to the manufacturer that provided the information.
            ``(C) The Secretary shall establish written procedures to 
        ensure the confidentiality of information provided under 
        paragraph (3).
            ``(5) Prohibition on additional shipping or handling 
        charges.--Each contract for the purchase of recommended 
        childhood vaccine under this section shall contain a provision 
        by which the manufacturer agrees to ship or otherwise arrange 
        for the delivery of such vaccine in accordance with the 
        distribution plan of the Secretary (or a State, as the case may 
        be) without imposing any additional charge for shipping, 
        handling, or any other cost on the health care provider or 
        State to which the vaccine is shipped or delivered.
            ``(6) Multiple suppliers.--To ensure a reliable and 
        adequate supply of vaccine, the Secretary may enter into 
        contracts with multiple manufacturers of the same recommended 
        childhood vaccine, under such terms and conditions and 
        utilizing such procurement processes as the Secretary deems 
        appropriate.
            ``(7) Reporting requirements.--Each contract for the 
        purchase of recommended childhood vaccine under this section 
        shall require the manufacturer to report to the Secretary or 
        the Secretary's designee, at intervals determined by the 
        Secretary, data regarding the destination of vaccine by lot 
        number, and any other information the Secretary may require.

``SEC. 2142. DISTRIBUTION OF VACCINES.

    ``(a) In General.--The Secretary shall provide for the distribution 
without charge of recommended childhood vaccines purchased under this 
subtitle to health care providers who serve children and who (1) are 
members of a uniformed service, or are officers or employees of the 
United States, (2) are health centers (as defined in section 2144(2)), 
(3) provide services under section 503 of the Indian Health Care 
Improvement Act or pursuant to a contract under section 102 of the 
Indian Self-Determination Act, or (4) are located in a State receiving 
a grant under section 2143(b). The Secretary may provide for such 
distribution through any State that receives a grant under section 
2143(b).
    ``(b) Duties of Health Care Providers.--
            ``(1) Free provision to children.--A health care provider 
        receiving vaccine under this section may use such vaccine only 
        for administration to children and may not impose a charge for 
        such vaccine. A provider may impose a fee for the 
        administration of such vaccine, except that a provider may not 
        deny a child a vaccination due to inability of the child's 
        parent or guardian to pay an administration fee.
            ``(2) Reporting requirements.--A health care provider 
        receiving vaccine under this section shall report to the 
        applicable State registry operated pursuant to a grant under 
        section 2143(b) (or to the Secretary if there is no such State 
        registry) the data described in section 2143(b)(1) for each 
        dose of vaccine administered to a child. The provider shall 
        additionally report to such State registry any occurrence 
        reported to the Secretary pursuant to section 2125(b). The 
        provider shall also provide periodic estimates of the 
        provider's future dosage needs for recommended childhood 
        vaccine distributed under this section. All reports shall be 
        made with such frequency and in such detail as the Secretary 
        may prescribe.

``SEC. 2143. TRACKING OF CHILDHOOD IMMUNIZATIONS.

    ``(a) National Tracking System.--The Secretary shall establish a 
national system to track the immunization status of children. The 
system shall be designed to obtain timely information about the 
immunization status of individual children and to monitor immunization 
rates at the State and local levels. In addition, the system shall be 
designed to monitor the safety and efficacy of vaccines, and to provide 
for the coordination of vaccine administration information with the 
information on adverse events reported under section 2125(b). In 
addition, the Secretary is authorized, in the case of inadequately 
immunized children in States not receiving grants under subsection (b), 
to notify the parents or guardians of those children of the need to 
protect their children with specific vaccine.
    ``(b) State Registry Grants.--
            ``(1) In general.--The Secretary may make grants to States 
        to establish and operate State immunization tracking 
        registries. A State receiving a grant under this section shall 
        maintain a registry that includes the following information for 
        each child living within the State:
                    ``(A) type and lot number of each recommended 
                childhood vaccine administered after September 30, 
                1996,
                    ``(B) identification of the health care provider 
                administering such vaccine,
                    ``(C) address and other demographic data needed to 
                find the child,
                    ``(D) notations of any adverse events associated 
                with each immunization, and
                    ``(E) such other information as the Secretary may 
                prescribe.
            ``(2) Grant conditions.--A State, as a condition of 
        receiving a grant under this subsection, shall comply with the 
        following requirements:
                    ``(A) The State registry shall provide for entry of 
                the birth of each infant within the State within six 
                weeks following the birth, and for timely entry 
                thereafter of all information received from health care 
                providers pursuant to section 2142(b)(2).
                    ``(B) The State shall provide for the sharing of 
                appropriate information from the State's registry, 
                including immunization status and reports of adverse 
                reactions, with health care providers who offer 
                immunizations, for the purpose of achieving the full 
                immunization of all children in accordance with the 
                recommendations of the Secretary under section 2141(a).
                    ``(C) The State shall provide for notification to 
                the parents or guardian of an inadequately immunized 
                child of the need to protect the child with specific 
                vaccine.
                    ``(D) The State shall provide for the coordination 
                and exchange of information with other State registries 
                to allow the tracking of the immunization status of 
                children changing state of residence.
                    ``(E) The State shall periodically furnish to the 
                Secretary, at such times and in such form as the 
                Secretary may prescribe, information contained in the 
                State registry.
                    ``(F) In designing its registry, the State shall 
                adhere to tracking models and systems specifications 
                prescribed by the Secretary for the purpose of ensuring 
                the mutual compatibility of the data systems and 
                electronic information technology utilized by the 
                Secretary and the various States in carrying out 
                activities under this subtitle.
                    ``(G) The State shall monitor and enforce 
                compliance by health care providers with the 
                requirements of section 2142(b). The State shall 
                establishes procedures satisfactory to the Secretary 
                for terminating from participation in the recommended 
                childhood vaccine distribution program any health care 
                provider who fails to comply with the requirements of 
                section 2142(b), and for reinstating such provider to 
                program participation upon receiving from such provider 
                (i) the reports necessary to make current and complete 
                the information that would have been furnished to the 
                State registry between the dates of the provider's 
                termination and reinstatement, and (ii) satisfactory 
                assurances regarding the provider's future compliance.
                    ``(H) If a State distributes recommended childhood 
                vaccines within the State on behalf of the Secretary 
                pursuant to section 2142(a), the State shall compile 
                data, including lot numbers, on the vaccines 
                distributed to each health care provider, and shall 
                furnish such data to the Secretary in such form and at 
                such intervals as the Secretary may prescribe.
            ``(3) Applications.--A State shall submit an application 
        for a grant under subsection (b) in such form and containing 
        such information as the Secretary may prescribe. The 
        application shall include a description of the methods by which 
        the State will comply with the requirements of paragraph (2). 
        The application shall also include the assurances required by 
        paragraph (4) and a description of the expenses that the State 
        will incur in carrying out its responsibilities under the 
        grant.
            ``(4) A State submitting an application for a grant under 
        this section shall provide assurances satisfactory to the 
        Secretary that--
                    ``(A) the State's tracking registry will be fully 
                operational not later than October 1, 1996;
                    ``(B) the State's tracking registry will adhere to 
                any tracking models and systems specifications 
                prescribed by the Secretary pursuant to paragraph 
                (2)(F); and
                    ``(C) as appropriate, the State is making 
                satisfactory and timely progress toward achieving the 
                conditions described in subparagraphs (A) and (B).
            ``(5) Allowable uses of grant funds.--A State may use funds 
        from a grant awarded under this subsection for reasonable costs 
        associated with the development and operation of its registry, 
        including computer needs, technical assistance and training, 
        education of health care providers, personnel costs, travel 
        expenses, and other appropriate activities.
            ``(6) State reports to the secretary.--A State shall submit 
        periodic reports to the Secretary on the operation of the 
        State's registry and other activities under this subtitle. The 
        reports shall be in such form, contain such information, and be 
        submitted at such intervals as the Secretary may prescribe.
    ``(c) Use and Disclosure of Personal Information.--
            ``(1) Notwithstanding any other provision of this subtitle, 
        no personally-identifiable information relating to a child who 
        receives recommended childhood vaccine under this subtitle or 
        to the parent or guardian of such a child that is collected or 
        maintained by the National Tracking System established under 
        subsection (a), or a State immunization tracking registry 
        established under subsection (b), may be used or disclosed by 
        any holder of such information except as permitted by this 
        subsection.
            ``(2) Information described in paragraph (1) may be used or 
        disclosed, without the consent of the individual to whom it 
        refers, or of the parent or guardian of such individual, for--
                    ``(A) the tracking of children's immunization 
                status, and other purposes directly related to the 
                health of the children being tracked and of their 
                families;
                    ``(B) oversight, audit, and evaluation of the 
                immunization delivery and tracking activities, and the 
                enforcement of the provisions of this subtitle;
                    ``(C) activities relating to establishing and 
                maintaining a safe and effective supply of recommended 
                childhood vaccine (including activities to carry out 
                part C of subtitle 2);
                    ``(D) processing of insurance claims for payment 
                for vaccine administration (but only to the extent 
                necessary to process a claim);
                    ``(E) administration of the National Vaccine Injury 
                Compensation Program under subtitle 2; or
                    ``(F) health research, including research on the 
                delivery and financing of health services.
            ``(3) Information described in paragraph (1) may be used or 
        disclosed with the written authorization of the individual to 
        whom it refers, or the parent or guardian of such individual, 
        and must, upon the request of such individual, or parent or 
        guardian, be provided in writing to the individual.
            ``(4) The Secretary is authorized to issue regulations 
        governing the use, maintenance, and disclosure, by any holder 
        of information described in paragraph (1), including 
        appropriate administrative, technical and physical safeguards 
        to ensure that only authorized persons have access to the 
        information.
            ``(5) Any person who knowingly--
                    ``(A) uses or discloses information in violation of 
                this subsection, or
                    ``(B) requests or obtains any information in 
                violation of this subsection, and offers or provides 
                anything of value in exchange for the provision of the 
                information,
        shall be fined as prescribed by title 18, United States Code, 
        or imprisoned not more than 3 years, or both.''
    ``(d) Authority to Use Social Security Numbers.--
            ``(1) In general.--Notwithstanding section 205 of the 
        Social Security Act or any other provision of law, the 
        Secretary and States receiving grants under subsection (b) may 
        utilize the social security number of a child or of a parent or 
        guardian of the child for purposes of identification of a child 
        in any registry established under this section, and may require 
        a child's parent or guardian to furnish such number (in any 
        case where such a number has been assigned by the Social 
        Security Administration) as a condition of the child receiving 
        recommended childhood vaccine under this subtitle.
            ``(2) Authority to redisclose.--Notwithstanding section 
        205(c)(2)(C)(vii)(I) of the Social Security Act, a social 
        security number obtained in connection with activities under 
        this subtitle may be redisclosed if such redisclosure is 
        otherwise in accordance with subsection (c) of this section.
    ``(e) Reports by Secretary to the Congress.--The Secretary shall 
submit a report to Congress not later than January 1, 1996, and 
biennially thereafter on the operation of the national tracking system 
and the State registries.

``SEC. 2144. DEFINITIONS.

    ``For purposes of this subtitle--
            ``(1) The term `recommended childhood vaccine' is a vaccine 
        on the list promulgated by the Secretary pursuant to section 
        2141(a).
            ``(2) The term `health center' means--
                    ``(A) a federally qualified health center, as 
                defined in section 1905(l)(2) of the Social Security 
                Act; or
                    ``(B) a public or nonprofit private entity 
                receiving Federal funds under--
                            ``(i) section 340A (relating to grants for 
                        health services for residents of public 
                        housing), or
                            ``(ii) section 501(a)(2) of the Social 
                        Security Act (relating to special projects of 
                        regional and national significance).

``SEC. 2145. APPROPRIATIONS AND AUTHORIZATION.

    ``(a) Vaccine Purchases.--There shall be made available for 
expenditure by the Secretary, out of the Comprehensive Child 
Immunization Account in the Treasury established pursuant to section 6 
of the Comprehensive Child Immunization Act of 1993, such amounts as 
are required to carry out subsections (b) and (c) of section 2141 for 
fiscal year 1995 and for each fiscal year thereafter during which such 
subsections remain in effect.
    ``(b) Other Activities.--For carrying out this subtitle other than 
subsections (b) and (c) of section 2141, there are authorized to be 
appropriated $152,000,000 for fiscal year 1995, $125,000,000 for fiscal 
year 1996, and $35,000,000 for each of fiscal years 1997, 1998, and 
1999.
    ``(c) In addition to other amounts available for carrying out title 
III and subtitle 1 of title XXI, there are authorized to be 
appropriated for fiscal years 1993 and 1994 such additional sums as may 
be necessary for activities related to and preparatory to 
implementation of this subtitle, including infrastructure improvements, 
information and education, surveillance and response, and vaccine 
safety.''.
    (b) Requirements Concerning Immunizations of Children Under State 
Medicaid Programs.--
            (1) Coverage of immunizations under early and periodic 
        screening, diagnosis, and testing (EPSDT).--Section 
        1905(r)(1)(B)(iii) of the Social Security Act is amended to 
        read as follows:
                            ``(iii) appropriate immunizations according 
                        to the recommendations of the Secretary 
                        promulgated under section 2141(a) of the Public 
                        Health Service Act, taking into account the 
                        health history of the individual,''.
            (2) Reimbursement rates for immunizations with recommended 
        childhood vaccines.--Section 1902(a)(13) of the Social Security 
        Act is amended--
                    (A) by striking ``and'' and the end of subparagraph 
                (E),
                    (B) by inserting ``and'' at the end of subparagraph 
                (F), and
                    (C) by adding at the end the following new 
                subparagraph:
                    ``(G) that payments to providers shall include 
                amounts, as appropriate, as reimbursement for 
                administration of recommended childhood vaccines (as 
                defined in section 2144 of the Public Health Service 
                Act) in accordance with section 1905(r)(i)(B)(iii);''.
            (3) Effective date.--(A) In general.--Except as provided in 
        subparagraph (B), the amendments made by this subsection shall 
        be effective with respect to calendar quarters beginning on or 
        after October 1, 1994.
            (B) Extension for state law amendment.--In the case of a 
        State plan under title XIX of the Social Security Act which the 
        Secretary of Health and Human Services determines requires 
        State legislation in order for the plan to meet the additional 
        requirements imposed by the amendments made by paragraph (2), 
        the State plan shall not be regarded as failing to comply with 
        the requirements of such title solely on the basis of its 
        failure to meet these additional requirements before the first 
        day of the first calendar quarter beginning after the close of 
        the first regular session of the State legislature that begins 
        after the date of enactment of this Act. For purposes of the 
        previous sentence, in the case of a State that has a two-year 
        legislative session, each year of such session shall be deemed 
        to be a separate regular session of the State legislature.
    (c) Termination of Purchase Program.--Subsections (b) and (c) of 
section 2141 of the Public Health Service Act (as added by subsection 
(a) of this section) shall cease to be in effect beginning on such date 
as may be prescribed in Federal law providing for immunization services 
for all children as part of a broad-based reform of the national health 
care system.

SEC. 5. NATIONAL VACCINE INJURY COMPENSATION PROGRAM AMENDMENTS.

    (a) Use of Vaccine Injury Compensation Trust Fund.--
            (1) Section 9510(c)(1) of the Internal Revenue Code of 1986 
        is amended by striking out ``, and before October 1, 1992,''.
            (2) Section 6601(r) of the Omnibus Budget Reconciliation 
        Act of 1989 is amended by striking out ``$2,500,000 for each of 
        fiscal years 1991 and 1992'' each place it appears and 
        inserting in lieu thereof ``$3,000,000 for fiscal year 1994 and 
        each fiscal year thereafter'' (in three places).
    (b) Permanent Extension of Authority to Impose Taxes For the 
Vaccine Injury Compensation Trust Fund.--
            (1) Permanent extension of tax.--Section 4131(c) of the 
        Internal Revenue Code of 1986 is repealed.
            (2) Reinstatement of tax.--The tax imposed by section 4131 
        of the Internal Revenue Code of 1986 is hereby reinstated 
        effective April 1, 1993.
    (c) Amendment of Vaccine Injury Table.--(1) Section 2114 is amended 
by adding at the end thereof the following new subsection:
    ``(f) Addition of Vaccines to Table.--The Vaccine Injury Table set 
out in subsection (a) also includes any recommended childhood vaccine 
included in the list promulgated by the Secretary under section 
2141(a). The Secretary may modify the Table with respect to any vaccine 
added by operation of the preceding sentence only in accordance with 
subsection (c). For purposes of section 2116(b), the addition of a 
vaccine to the Table by operation of the subsection shall constitute a 
revision of this Table.''.
    (2) Section 2116(b) is amended by striking out ``such person may 
file'' and inserting in lieu thereof ``or to significantly increase the 
likelihood of obtaining compensation, such person may, notwithstanding 
section 2111(b)(2), file''.
    (d) Extension of Time for Decision.--Section 2112(d)(3)(D) is 
amended by striking out ``540 days'' and inserting in lieu thereof ``30 
months (but for no more than 6 months at a time)''.
    (e) Simplification of Vaccine Information Materials.--
            (1) Section 2126 (b) is amended--
                    (A) by striking out ``by rule'' in the matter 
                preceding paragraph (1);
                    (B) by striking out, in paragraph (1), ``, 
                opportunity for a public hearing, and 90'' and 
                inserting in lieu thereof ``and 30''; and
                    (C) by striking out, in paragraph (2), ``, 
                appropriate health care providers and parent 
                organizations''.
            (2) Section 2126(c) is amended--
                    (A) by inserting ``shall be based on available data 
                and information,'' immediately after ``such materials'' 
                in the matter preceding paragraph (1), and
                    (B) by striking out paragraphs (1) through (10) and 
                inserting in lieu thereof the following:
                            ``(1) a concise description of the benefits 
                        of the vaccine,
                            ``(2) a concise description of the risks 
                        associated with the vaccine, and
                            ``(3) a statement of the availability of 
                        the National Vaccine Injury Compensation 
                        Program.''.
            (3) Subsections (a) and (d) of section 2126 are each 
        amended by inserting ``or to any other individual'' immediately 
        after ``to the legal representative of any child''.
            (4) Subsection (d) of section 2126 is amended--
                    (A) by striking out all after ``subsection (a),'' 
                the second place it appears in the first sentence and 
                inserting in lieu thereof ``supplemented with visual 
                presentations or oral explanations, in appropriate 
                cases.'', and
                    (B) by striking ``or other information'' in the 
                last sentence.

SEC. 6. FUNDING FOR CHILD IMMUNIZATION PROGRAM.

    (a) Maintenance of Separately Identifiable Account.--There shall be 
established in the Treasury of the United States the Comprehensive 
Child Immunization Account for the purpose of funding activities under 
subsections (b) and (c) of section 2141 of the Public Health Service 
Act.
    (b) Source of Receipts.--Receipts shall be credited to the Account 
established under subsection (a) as may be provided in Federal law.

                                 <all>

HR 1640 SC2----2
HR 1640 SC2----3