[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1747 Introduced in House (IH)]

  1st Session
                                H. R. 1747

   To amend the Public Health Service Act to permanently extend and 
    clarify malpractice coverage for health centers, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              June 6, 1995

 Mrs. Johnson of Connecticut (for herself, Mr. Wyden, and Mr. Frank of 
Massachusetts) introduced the following bill; which was referred to the 
                         Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to permanently extend and 
    clarify malpractice coverage for health centers, 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; REFERENCE.

    (a) Short Title.--This Act may be cited as the ``Federally 
Supported Health Centers Assistance Act of 1995''.
    (b) Reference.--Except as otherwise expressly provided, whenever in 
this Act an amendment or repeal is expressed in terms of an amendment 
to, or repeal of, a section or other provision, the reference shall be 
considered to be made to a section or other provision of the Public 
Health Service Act.

SEC. 2. PERMANENT EXTENSION OF PROGRAM.

    (a) In General.--Section 224(g) (42 U.S.C. 233(g)) is amended by 
striking the last sentence of paragraph (3).
    (b) Conforming Amendments.--
            (1) Section 224(k)(1)(A) (42 U.S.C. 233(k)(1)(A)) is 
        amended by striking ``each of the fiscal years 1993, 1994, and 
        1995'' and inserting ``each fiscal year''.
            (2) Section 224(k)(2) (42 U.S.C. 233(k)(2)) is amended by 
        striking ``each of the fiscal years 1993, 1994, and 1995'' and 
        inserting ``each fiscal year''.

SEC. 3. CLARIFICATION OF COVERAGE.

    Section 224(g)(1) (42 U.S.C. 233(g)(1)) is amended--
            (1) in the first sentence, by striking ``officer, employee, 
        or contractor'' and inserting ``officer, governing board 
        member, or employee of such an entity, and any contractor''; 
        and
            (2) in the second sentence, by inserting after ``officer,'' 
        the following ``governing board member,''.

SEC. 4. COVERAGE FOR SERVICES FURNISHED TO INDIVIDUALS OTHER THAN 
              CENTER PATIENTS.

  Section 224(g)(1) (42 U.S.C. 233(g)) is amended--
            (1) by redesignating paragraph (1) as paragraph (1)(A); and
            (2) by adding at the end thereof the following:
            ``(B) The deeming of any entity or officer, governing board 
        member, employee, or contractor of the entity to be an employee 
        of the Public Health Service under subparagraph (A) shall apply 
        with respect to services provided--
                    ``(i) to all patients of the entity, and
                    ``(ii) subject to subparagraph (C), to individuals 
                who are not patients of the entity.
            ``(C) Subparagraph (B)(ii) applies to services provided to 
        individuals who are not patients of an entity if the Secretary 
        determines, after reviewing an application submitted under 
        subparagraph (D), that the provision of the services to such 
        individuals--
                    ``(i) benefits patients of the entity and general 
                populations that could be served by the entity through 
                community-wide intervention efforts within the 
                communities served by such entity;
                    ``(ii) facilitates the provision of services to 
                patients of the entity; or
                    ``(iii) are otherwise required under an employment 
                contract (or similar arrangement) between the entity 
                and an officer, governing board member, employee, or 
                contractor of the entity.''.

SEC. 5. APPLICATION PROCESS.

    (a) Application Requirement.--Section 224(g)(1) (42 U.S.C. 
233(g)(1)) (as amended by section 4) is further amended--
            (1) in subparagraph (A), by inserting ``and subject to the 
        approval by the Secretary of an application under subparagraph 
        (D)'' after ``For purposes of this section''; and
            (2) by adding at the end thereof the following:
            ``(D) The Secretary may not deem an entity or an officer, 
        governing board member, employee, or contractor of the entity 
        to be an employee of the Public Health Service under 
        subparagraph (A), and may not apply such deeming to services 
        described in subparagraph (B)(ii), unless the entity has 
        submitted an application for such deeming to the Secretary in 
        such form and such manner as the Secretary shall prescribe. The 
        application shall contain detailed information, along with 
        supporting documentation, to verify that the entity, and the 
        officer, governing board member, employee, or contractor of the 
        entity, as the case may be, meets the requirements of 
        subparagraphs (B) and (C) of this paragraph and that the entity 
        meets the requirements of paragraphs (1) through (4) of 
        subsection (h).
            ``(E) The Secretary shall make a determination of whether 
        an entity or an officer, governing board member, employee, or 
        contractor of the entity is deemed to be an employee of the 
        Public Health Service for purposes of this section within 30 
        days after the receipt of an application under subparagraph 
        (D). The determination of the Secretary that an entity or an 
        officer, governing board member, employee, or contractor of the 
        entity is deemed to be an employee of the Public Health Service 
        for purposes of this section shall apply for the period 
        specified by the Secretary under subparagraph (A).
            ``(F) Once the Secretary makes a determination that an 
        entity or an officer, governing board member, employee, or 
        contractor of an entity is deemed to be an employee of the 
        Public Health Service for purposes of this section, the 
        determination shall be
         final and binding upon the Secretary and the Attorney General 
and other parties to any civil action or proceeding. Except as provided 
in subsection (i), the Secretary and the Attorney General may not 
determine that the provision of services which are the subject of such 
a determination are not covered under this section or are not within 
the scope of employment or responsibility of the entity or its 
officers, governing board members, employees, or contractors.
            ``(G) The Secretary, for good cause shown, may reverse a 
        determination under subparagraph (E). The decision of the 
        Secretary to reverse such a determination shall be made on the 
        record after opportunity for a full and fair hearing. Any such 
        reversal by the Secretary shall apply only after the entity 
        receives notice of such reversal and shall only apply to acts 
        and omissions occurring after the date on which such notice was 
        received.''.
    (b) Approval Process.--Section 224(h) (42 U.S.C. 233(h)) is 
amended--
            (1) by striking the matter preceding paragraph (1) and 
        inserting the following: ``The Secretary may not approve an 
        application under subsection (g)(1)(D) unless the Secretary 
        determines that the entity--''; and
            (2) by striking ``has fully cooperated'' in paragraph (4) 
        and inserting ``will fully cooperate''.

SEC. 6. TIMELY RESPONSE TO FILING OF ACTION OR PROCEEDING.

    Section 224 (42 U.S.C. 233) is amended by adding at the end thereof 
the following:
    ``(l)(1) If a civil action or proceeding is filed in a State court 
against any entity described in subsection (g)(4) or any officer, 
governing board member, employee, or any contractor of such an entity 
for damages described in subsection (a), the Attorney General, within 
15 days after being notified of such filing, shall make an appearance 
in such court and advise such court as to whether the Secretary has 
determined under subsections (g) and (h), that such entity, officer, 
governing board member, employee, or contractor of the entity is deemed 
to be an employee of the Public Health Service for purposes of this 
section with respect to the actions or omissions that are the subject 
of such civil action or proceeding. Such advice shall be deemed to 
satisfy the provisions of subsection (c) that the Attorney General 
certify that an entity, officer, governing board member, employee, or 
contractor of the entity was acting within the scope of their 
employment or responsibility.
    ``(2) If the Attorney General fails to appear in State court within 
the time period prescribed under paragraph (1), upon petition of any 
entity or officer, governing board member, employee, or contractor of 
the entity named, the civil action or proceeding shall be removed to 
the appropriate United States district court. The civil action or 
proceeding shall be stayed in such court until such court conducts a 
hearing, and makes a determination, as to the appropriate forum or 
procedure for the assertion of the claim for damages described in 
subsection (a) and issues an order consistent with such 
determination.''.

SEC. 7. APPLICATION OF COVERAGE TO MANAGED CARE PLANS.

    Section 224 (42 U.S.C. 223) (as amended by section 6) is amended by 
adding at the end the following:
    ``(m)(1) An entity or officer, governing board member, employee, or 
contractor of an entity described in subsection (g)(1) shall, for 
purposes of this section, be deemed to be an employee of the Public 
Health Service with respect to services provided to individuals who are 
enrollees of a managed care plan if the entity contracts with such 
managed care plan for the provision of services.
    ``(2) Each managed care plan which enters into a contract with an 
entity described in subsection (g)(4) shall deem the entity and any 
officer, governing board member, employee, or contractor of the entity 
as meeting whatever malpractice coverage requirements such plan may 
require of contracting providers for a calendar year if such entity or 
officer, governing board member, employee, or contractor of the entity 
has been deemed to be an employee of the Public Health Service for 
purposes of this section for such calendar year. Any plan which is 
found by the Secretary on the record, after notice and an opportunity 
for a full and fair hearing, to have violated this subsection shall 
upon such finding cease, for a period to be determined by the 
Secretary, to receive and to be eligible to receive any Federal funds 
under titles XVIII or XIX of the Social Security Act.
    ``(3) For purposes of this subsection, the term `managed care plan' 
shall mean health maintenance organizations and similar entities that 
contract at-risk with payors for the provision of health services or 
plan enrollees and which contract with providers (such as entities 
described in subsection (g)(4)) for the delivery of such services to 
plan enrollees.''.

SEC. 8. COVERAGE FOR PART-TIME PROVIDERS UNDER CONTRACTS.

    Section 224(g)(5)(B) (42 U.S.C. 223(g)(5)(B)) is amended to read as 
follows:
                    ``(B) in the case of an individual who normally 
                performs an average of less than 32\1/2\ hours of 
                services per week for the entity for the period of the 
                contract, the individual is a licensed or certified 
                provider of services in the fields of family practice, 
                general internal medicine, general pediatrics, or 
                obstetrics and gynecology.''.

SEC. 9. DUE PROCESS FOR LOSS OF COVERAGE.

    Section 224(i)(1) (42 U.S.C. 233(i)(1)) is amended by striking 
``may determine, after notice and opportunity for a hearing'' and 
inserting ``may on the record determine, after notice and opportunity 
for a full and fair hearing''.

SEC. 10. AMOUNT OF RESERVE FUND.

    Section 224(k)(2) (42 U.S.C. 223(k)(2)) is amended by striking 
``$30,000,000'' and inserting ``$10,000,000''.
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