[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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