[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1747 Reported in House (RH)]
Union Calendar No. 204
104th CONGRESS
1st Session
H. R. 1747
[Report No. 104-398]
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to permanently extend and
clarify malpractice coverage for health centers, and for other
purposes.
_______________________________________________________________________
December 12, 1995
Reported with amendments, committed to the Committee of the Whole House
on the State of the Union, and ordered to be printed
Union Calendar No. 204
104th CONGRESS
1st Session
H. R. 1747
[Report No. 104-398]
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
December 12, 1995
Additional sponsors: Mr. Goss, Mr. Sanders, Mr. Barrett of Wisconsin,
Mr. Callahan, Mr. Ehlers, Mr. Williams, Mr. Stupak, Mr. Mascara, Mr.
Hastert, Mr. Kolbe, Mr. Gutierrez, Mr. Tauzin, Mrs. Collins of
Illinois, Mr. Waxman, Mr. Serrano, Mr. Engel, Mr. Wicker, Mr. Moorhead,
Mr. Greenwood, Ms. Pelosi, Ms. Molinari, Mr. Dingell, Mr. Tejeda, Mr.
Payne of Virginia, Mr. Bonior, Mr. Dellums, Mr. Blute, Mr. Stenholm,
Mrs. Kelly, Mr. Kildee, Mr. Pastor, and Mr. Kennedy of Rhode Island
December 12, 1995
Reported with amendments, committed to the Committee of the Whole House
on the State of the Union, and ordered to be printed
[Strike out all after the enacting clause and insert the part printed
in italic]
[For text of introduced bill, see copy of bill as introduced on June 6,
1995]
_______________________________________________________________________
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; REFERENCES.
(a) Short Title.--This Act may be cited as the ``Federally
Supported Health Centers Assistance Act of 1995''.
(b) References.--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. EXTENSION OF PROGRAM.
(a) In General.--Section 224(g)(3) (42 U.S.C. 233(g)(3)) is amended
in the last sentence by striking ``January 1, 1996'' and inserting
``January 1, 1999''.
(b) Conforming Amendments.--Section 224(k) (42 U.S.C. 233(k)) is
amended--
(1) in paragraph (1)(A), by striking ``each of the fiscal
years 1993, 1994, and 1995'' and inserting ``each of the fiscal
years 1996 through 1998''; and
(2) in paragraph (2), by striking ``each of the fiscal
years 1993, 1994, and 1995'' and inserting ``each of the fiscal
years 1996 through 1998''.
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.''.
(b) Approval Process.--Section 224(h) (42 U.S.C. 233(h)) is
amended--
(1) in the matter preceding paragraph (1), by striking
``Notwithstanding'' and all that follows through ``entity--''
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 subsection:
``(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 thereof the following subsection:
``(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''.
SEC. 11. REPORT ON RISK EXPOSURE OF COVERED ENTITIES.
Section 224 (as amended by section 7) is amended by adding at the
end thereof the following subsection:
``(n)(1) Not later than April 1, 1997, the Secretary, in
consultation with the Attorney General, shall submit to the Congress a
report on the medical malpractice liability claims experience of
entities that have been deemed to be employees for purposes of this
section, and the risk exposure associated with such entities.
``(2) The report under paragraph (1) shall include an analysis by
the Secretary comparing--
``(A) the Secretary's estimate of the aggregate amounts
that such entities (together with the officers, governing board
members, employees, and contractors of such entities who have
been deemed to be employees for purposes of this section) would
have directly or indirectly paid to obtain medical malpractice
liability insurance coverage if this section were not in
effect; with
``(B) the aggregate amounts by which the grants received by
such entities under this Act were reduced pursuant to
subsection (k)(2).
``(3) In preparing the report under paragraph (1), the Secretary
shall consult with public and private entities with expertise on the
matters with which the report is concerned.''.
Amend the title so as to read: ``A bill to amend the Public
Health Service Act to extend and clarify malpractice coverage
for health centers, and for other purposes.''.