[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 1959 Introduced in Senate (IS)]







106th CONGRESS
  1st Session
                                S. 1959

  To provide for the fiscal responsibility of the Federal Government.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           November 18, 1999

  Mr. Harkin introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
  To provide for the fiscal responsibility of the Federal Government.

    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 ``Fiscal 
Responsibility Act of 1999''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
 TITLE I--INCREASED ACCOUNTABILITY AND ELIMINATION OF WASTEFUL SPENDING

        Subtitle A--Penalties for Failure to Reduce Teen Smoking

Sec. 101. Child cigarette use surveys.
Sec. 102. Cigarette use reduction goal and noncompliance.
Sec. 103. Enforcement.
                    Subtitle B--Tobacco Advertising

Sec. 111. Disallowance of deductions for advertising and promotional 
                            expenses relating to tobacco product use.
                 Subtitle C--Medicare Waste Elimination

Sec. 121. Short title.
Sec. 122. Increased medical reviews and antifraud activities.
Sec. 123. Oversight of home health agencies.
Sec. 124. No markup for drugs or biologicals.
Sec. 125. Ensuring that the medicare program does not reimburse claims 
                            owed by other payers.
Sec. 126. Extension of subpoena and injunction authority.
Sec. 127. Civil monetary penalties for services ordered or prescribed 
                            by an excluded individual or entity.
Sec. 128. Civil monetary penalties for false certification of 
                            eligibility to receive partial 
                            hospitalization and hospice services.
Sec. 129. Application of certain provisions of the bankruptcy code.
Sec. 130. Improving private sector coordination in combatting health 
                            care fraud.
Sec. 131. Fees for agreements with medicare providers and suppliers.
Sec. 132. Increased medicare compliance, education, and assistance for 
                            health care providers.
Sec. 133. Paperwork and administrative hassle reduction.
Sec. 134. Clarification of application of sanctions to Federal health 
                            care programs.
Sec. 135. Payments for durable medical equipment.
Sec. 136. Implementation of commercial claims auditing systems.
Sec. 137. Partial hospitalization payment reforms.
Sec. 138. Expansion of medicare senior waste patrol nationwide.
Sec. 139. Application of inherent reasonableness to all part B services 
                            other than physicians' services.
Sec. 140. Standards regarding payment for certain orthotics and 
                            prosthetics.
Sec. 141. Increased flexibility in contracting for medicare claims 
                            processing.
               Subtitle D--Reduction in Student Loan Fees

Sec. 151. Reduction in student loan fees.
   Subtitle E--Limitations on Defense Funding for Fiscal Years 2000 
                              Through 2004

Sec. 161. Budget authority.
Sec. 162. Protection of readiness and quality of life.
Sec. 163. Expenditures not considered emergency expenditures.
              Subtitle F--Internal Revenue Code Provisions

Sec. 171. Recapture of unified credit for large estates.
Sec. 172. Repeal of percentage depletion for certain nonfuel minerals 
                            mined on Federal lands.
Sec. 173. Repeal of foreign earned income exclusion.
Sec. 174. Depreciation adjustments for tobacco manufacturing equipment.
Sec. 175. Foreign oil and gas income.
Sec. 176. Transfer pricing.
     TITLE II--MISCELLANEOUS PROVISIONS TO REDUCE WASTEFUL SPENDING

Sec. 201. Prohibition on funding Television Marti and Radio Marti.
Sec. 202. Prohibition of use of Federal funds for lobbying.
Sec. 203. Prohibition of funding of the nuclear energy research 
                            initiative.
Sec. 204. Reduction in government agency spending on travel, printing, 
                            supplies and other items.
Sec. 205. Reducing student loan defaults.

 TITLE I--INCREASED ACCOUNTABILITY AND ELIMINATION OF WASTEFUL SPENDING

        Subtitle A--Penalties for Failure to Reduce Teen Smoking

SEC. 101. CHILD CIGARETTE USE SURVEYS.

    (a) Annual Performance Survey.--
            (1) In general.--Not later than August 31, 2000, and 
        annually thereafter, the Secretary of Health and Human Services 
        (referred to in this section as the ``Secretary'') shall 
        publish the results of an annual cigarette survey, to be 
        carried out after the date of enactment of this Act and 
        completed prior to August 21, 2000, and prior to August 21 of 
        each year thereafter, to determine--
                    (A) the percentage of all young individuals who 
                used a type of cigarette within the 30-day period prior 
                to the conduct of the survey involved; and
                    (B) the percentage of young individuals who 
                identify each brand of each type of cigarette as the 
                usual brand smoked within such 30-day period.
            (2) Young individuals.--For the purposes of this title, the 
        term ``young individuals'' means individuals who are under 18 
        years of age.
    (b) Size and Methodology.--
            (1) In general.--The survey referred to in subsection (a) 
        shall be comparable in size and methodology to the Monitoring 
        the Future survey that was completed in 1999 to measure the use 
        of cigarettes (by brand) by youths under 18 years of age within 
        the 30 day period prior to the conduct of the study.
            (2) Conclusive accurateness.--A survey using the 
        methodology described in paragraph (1) shall be deemed 
        conclusively proper, correct and accurate for purposes of this 
        section.
            (3) Definition.--In this subtitle, the term ``Monitoring 
        the Future survey'' means the combined survey of 8th, 10th, and 
        12th grade students that was conducted at the Institute for 
        Social Research at the University of Michigan.
    (c) Reduction.--The Secretary, based on a comparison of the results 
of the first annual cigarette survey referred to in subsection (a) and 
the Monitoring the Future survey referred to in subsection (b)(1), 
shall determine the percentage reduction (if any) in youth cigarette 
use for each manufacturer of cigarettes.
    (d) Participation in Survey.--Notwithstanding any other provision 
of law, the Secretary may conduct a survey under this section involving 
minors if the results of such survey with respect to such minors are 
kept confidential and not disclosed.
    (e) Nonapplicability.--Chapter 35 of title 44, United States Code, 
shall not apply to information required for the purposes of carrying 
out this section.
    (f) Definition.--In this subtitle the term ``cigarette'' has the 
meaning given such term in section 3(1) of the Federal Cigarette 
Labeling and Advertising Act (15 U.S.C. 1332(1)).

SEC. 102. CIGARETTE USE REDUCTION GOAL AND NONCOMPLIANCE.

    (a) Goal.--It shall be the cigarette use reduction goal that each 
manufacturer reduce youth cigarette use by at least 15 percent during 
the period between the Monitoring the Future survey referred to in 
section 101(b)(1) and the completion of the first annual cigarette 
survey (and such subsequent surveys as compared to the previous year's 
survey) referred to in section 101(a).
    (b) Noncompliance.--
            (1) Industry-wide penalty.--If the Secretary determines 
        that the cigarette use reduction goal under subsection (a) has 
        not been achieved, the Secretary shall, not later than 
        September 10, 2000, and September 10 of each year thereafter, 
        impose an industry-wide penalty on the manufacturers of 
        cigarettes in an amount that is in the aggregate equal to--
                    (A) if youth cigarette use has been reduced by 5 
                percent or less, $8,000,000,000;
                    (B) if youth cigarette use has been reduced by at 
                least 6 percent but less than 10 percent, 
                $6,000,000,000; and
                    (C) if youth cigarette use has been reduced by at 
                least 11 percent but less than 15 percent, 
                $4,000,000,000.
            (2) Payment.--The industry-wide penalty imposed under this 
        subsection shall be paid by each manufacturer based on the 
        percentage of cigarettes of each such manufacturer that are 
        used by youth (as determined under the Monitoring the Future 
        survey and compared to the cigarettes manufactured by all 
        manufacturers) as such percentage relates to the total amount 
        to be paid by all manufacturers.
            (3) Final determination.--The determination of the 
        Secretary as to the amount and allocation of a surcharge under 
        this subtitle shall be final and the manufacturer shall pay 
        such surcharge within 10 days of the date on which the 
        manufacturer is assessed. Such payment shall be retained by the 
        Secretary pending final judicial review of what, if any, change 
        in the surcharge is appropriate.
            (4) Compliance by certain manufacturers.--A manufacturer 
        that individually complies with the goal under subsection (a) 
        shall not be liable for the payment of any portion of the 
        penalty under this subsection.
            (5) Limitation.--With respect to cigarettes, a manufacturer 
        with a market share of 1 percent or less of youth cigarette use 
        shall not be liable for the payment of a surcharge under this 
        section.
    (c) Penalties Nondeductible.--The payment of penalties under this 
subtitle shall not be considered to be an ordinary and necessary 
expense in carrying on a trade or business for purposes of the Internal 
Revenue Code of 1986 and shall not be deductible.
    (d) Judicial Review.--
            (1) After payment.--A manufacturer of cigarettes may seek 
        judicial review of any action under this subtitle only after 
        the assessment involved has been paid by the manufacturer to 
        the Department of the Treasury and only in the United States 
        District Court for the District of Columbia.
            (2) Review by attorney general.--Prior to the filing of an 
        action by a manufacturer seeking judicial review of an action 
        under this subtitle, the manufacturer shall notify the Attorney 
        General of such intent to file and the Attorney General shall 
        have 30 days in which to respond to the action.
            (3) Review.--The amount of any surcharge paid under this 
        subtitle shall be subject to judicial review by the United 
        States Court of Appeals for the District of Columbia Circuit, 
        based on the arbitrary and capricious standard of section 706 
        of title 5, United States Code. Notwithstanding any other 
        provision of law, no court shall have the authority to stay any 
        surcharge payment due to the Secretary under this subtitle 
        pending judicial review until the Secretary has made or failed 
        to make a compliance determination, as described under this 
        subtitle, that has adversely affected the person seeking the 
        review.

SEC. 103. ENFORCEMENT.

    (a) Initial Penalty.--There is hereby imposed an initial penalty on 
the failure of any manufacturer to make any payment required under this 
subtitle within 10 days after the date on which such payment is due.
    (b) Amount of Penalty.--The amount of the penalty imposed by 
subsection (a) on any failure with respect to a manufacturer shall be 
an amount equal to 2 percent of the penalty owed under section 102 for 
each day during the noncompliance period.
    (c) Noncompliance Period.--For purposes of this section, the term 
``noncompliance period'' means, with respect to any failure to make the 
surcharge payment required under this subtitle, the period--
            (1) beginning on the due date for such payment; and
            (2) ending on the date on which such payment is paid in 
        full.
    (d) Limitations.--No penalty shall be imposed by subsection (a) 
on--
            (1) any failure to make a surcharge payment under this 
        subtitle during any period for which it is established to the 
        satisfaction of the Secretary that none of the persons 
        responsible for such failure knew or, exercising reasonable 
        diligence, would have known, that such failure existed; or
            (2) any manufacturer that produces less than 1 percent of 
        cigarettes used by youth in that year (as determined by the 
        annual survey).

                    Subtitle B--Tobacco Advertising

SEC. 111. DISALLOWANCE OF DEDUCTIONS FOR ADVERTISING AND PROMOTIONAL 
              EXPENSES RELATING TO TOBACCO PRODUCT USE.

    (a) In General.--Part IX of subchapter B of chapter 1 of subtitle A 
of the Internal Revenue Code of 1986 (relating to items not deductible) 
is amended by adding at the end the following new section:

``SEC. 280I. DISALLOWANCE OF DEDUCTION FOR TOBACCO ADVERTISING AND 
              PROMOTIONAL EXPENSES.

    No deduction shall be allowed under this chapter for expenses 
relating to advertising or promoting cigars, cigarettes, smokeless 
tobacco, pipe tobacco, or any similar tobacco product. For purposes of 
this section, any term used in this section which is also used in 
section 5702 shall have the same meaning given such term by section 
5702.''
    (b) Conforming Amendment.--The table of sections for such part IX 
is amended by adding after the item relating to section 280H the 
following new item:

                                  ``Sec. 280I. Disallowance of 
                                        deduction for tobacco 
                                        advertising and promotion 
                                        expenses.''
    (c) Effective Date.--The amendments made by this section shall 
apply to taxable years ending after December 31, 1999.

                 Subtitle C--Medicare Waste Elimination

SEC. 121. SHORT TITLE.

    This subtitle may be cited as the ``Medicare Waste Tax Reduction 
Act of 1999''.

SEC. 122. INCREASED MEDICAL REVIEWS AND ANTIFRAUD ACTIVITIES.

    Section 1893(d) of the Social Security Act (42 U.S.C. 1395ddd(d)) 
is amended by inserting after paragraph (3) the following:
            ``(4) In the case of the year 2000 and each subsequent 
        year, procedures to ensure that--
                    ``(A) the number of medical reviews, utilization 
                reviews, and fraud reviews in a fiscal year of 
                providers of services and other individuals and 
                entities furnishing items and services for which 
                payment may be made under this title (as a percentage 
                of total claims paid) is equal to at least twice the 
                number of such reviews that were conducted in fiscal 
                year 1999;
                    ``(B) the number of provider cost reports audited 
                in a fiscal year is equal to at least--
                            ``(i) 15 percent of those submitted by a 
                        home health agency or a skilled nursing 
                        facility; and
                            ``(ii) twice the number of such reports 
                        that were audited in fiscal year 1999 for those 
                        submitted by any other provider of services or 
                        any other individual or entity furnishing items 
                        and services for which payment may be made 
                        under this title; and
                    ``(C) in determining which providers of services, 
                individuals, entities, or cost reports to review or 
                audit, priority is placed on providers, individuals, 
                entities, and areas that the Secretary determines are 
                subject to abuse and most likely to result in 
                mispayment or overpayment recoveries.''.

SEC. 123. OVERSIGHT OF HOME HEALTH AGENCIES.

    Section 1891(c) of the Social Security Act (42 U.S.C. 1395bbb(c)) 
is amended by adding at the end the following:
    ``(3)(A)(i) The Secretary shall conduct onsite surveys of a 
representative sample of home health agencies in each State, in a 
sufficient number to allow inferences about the adequacies of each 
State's surveys conducted under this subsection.
    ``(ii) A survey described in clause (i) shall be conducted by the 
Secretary within 2 months of the date of the survey conducted by the 
State and may be conducted concurrently with the State survey.
    ``(iii) In conducting a survey described in clause (i), the 
Secretary shall use the same survey protocols as the State is required 
to use under this subsection.
    ``(iv) If, through a State survey, the State has determined that a 
home health agency is in compliance with the requirements specified in 
or pursuant to section 1861(o), this section, or this title, but the 
Secretary determines (after conducting the survey described in clause 
(i)) that the facility does not meet such requirements, the Secretary's 
determination as to the facility's noncompliance with such requirements 
is binding and supersedes that of the State survey.
    ``(B) With respect to each State, the Secretary shall conduct 
surveys under subparagraph (A) each year with respect to at least 5 
percent of the number of home health agencies surveyed by the State in 
the year, but in no case less than 5 home health agencies in the State.
    ``(C) If the Secretary finds, on the basis of such surveys, that a 
State has failed to perform surveys as required under this subsection 
or that a State's survey and certification performance otherwise is not 
adequate, the Secretary shall provide for an appropriate remedy, which 
may include the training of survey teams in the State.
    ``(D) If the Secretary has reason to question the compliance of a 
home health agency with any of the requirements specified in or 
pursuant to section 1861(o), this section, or this title, the Secretary 
may conduct a survey of the agency and, on the basis of that survey, 
make independent and binding determinations concerning the extent to 
which the home health agency meets such requirements.''.

SEC. 124. NO MARKUP FOR DRUGS OR BIOLOGICALS.

    (a) In General.--Section 1842(o) of the Social Security Act (42 
U.S.C. 1395u(o)) is amended to read as follows:
    ``(o)(1) If a physician's, supplier's, or any other person's bill 
or request for payment for services includes a charge for a drug or 
biological for which payment may be made under this part and the drug 
or biological is not paid on a cost or prospective payment basis as 
otherwise provided in this part, the payment amount established in this 
subsection for the drug or biological shall be the lowest of the 
following:
            ``(A) The actual acquisition cost, as defined in paragraph 
        (2), to the person submitting the claim for payment for the 
        drug or biological.
            ``(B) 83 percent of the average wholesale price of such 
        drug or biological, as determined by the Secretary.
            ``(C) For payments for any drug or biological furnished on 
        or after January 1, 2001, the median actual acquisition cost of 
        all claims for payment for such drug or biological for the 12-
        month period beginning July 1, 1999 (and adjusted, as the 
        Secretary determines appropriate, to reflect changes in the 
        cost of such drug or biological due to inflation, and such 
        other factors as the Secretary determines appropriate).
            ``(D) The amount otherwise determined under this part.
    ``(2) For purposes of paragraph (1)(A), the term `actual 
acquisition cost' means, with respect to such drug or biological, the 
cost of the drug or biological based on the most economical case size 
in inventory on the date of dispensing or, if less, the most economical 
case size purchased within 6 months of the date of dispensing whether 
or not that specific drug or biological was furnished to an individual 
whether or not enrolled under this part. Such term includes appropriate 
adjustments, as determined by the Secretary, for all discounts, 
rebates, or any other benefit in cash or in kind (including travel, 
equipment, or free products). The Secretary shall include an additional 
payment for administrative, storage, and handling costs.
    ``(3)(A) No payment shall be made under this part for any drug or 
biological to a person whose bill or request for payment for such drug 
or biological does not include a statement of the person's actual 
acquisition cost.
    ``(B) A person may not bill an individual enrolled under this 
part--
            ``(i) any amount other than the payment amount specified in 
        paragraph (1) or (4) (plus any applicable deductible and 
        coinsurance amounts), or
            ``(ii) any amount for such drug or biological for which 
        payment may not be made pursuant to subparagraph (A).
    ``(C) If a person knowingly and willfully in repeated cases bills 1 
or more individuals in violation of subparagraph (B), the Secretary may 
apply sanctions against that person in accordance with subsection 
(j)(2).
    ``(4) The Secretary may pay a reasonable dispensing fee (less the 
applicable deductible and coinsurance amounts) for any drug or 
biological to a licensed pharmacy approved to dispense drugs or 
biologicals under this part, if payment for such drug or biological is 
made to the pharmacy.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to drugs or biologicals furnished on or after January 1, 2000.
    (c) Elimination of Report on Average Wholesale Price.--Section 4556 
of the Balanced Budget Act of 1997 is amended by striking subsection 
(c).

SEC. 125. ENSURING THAT THE MEDICARE PROGRAM DOES NOT REIMBURSE CLAIMS 
              OWED BY OTHER PAYERS.

    (a) Information From Group Health Plans.--Section 1862(b) of the 
Social Security Act (42 U.S.C. 1395y(b)) is amended by adding at the 
end the following:
            ``(7) Information from group health plans.--
                    ``(A) Provision of information by group health 
                plans.--The administrator of a group health plan that 
                is subject to the requirements of paragraph (1) shall 
                provide the Secretary with the information described in 
                subparagraph (C) for each individual covered under the 
                plan who is entitled to any benefits under this title. 
                Such information shall be provided in such manner and 
                at such times as the Secretary may specify (but in no 
                case more frequently than 4 times per year).
                    ``(B) Provision of information by employers and 
                employee organizations.--An employer (or employee 
                organization) that maintains or participates in a group 
                health plan that is subject to the requirements of 
                paragraph (1) shall provide to the administrator of the 
                plan the information described in subparagraph (C) for 
                each individual covered under the plan who is entitled 
                to any benefits under this title. Such information 
                shall be provided in such manner and at such times as 
                the Secretary may specify (but in no case more 
                frequently than 4 times per year).
                    ``(C) Information.--The information described in 
                this subparagraph is as follows:
                            ``(i) Elements concerning the individual.--
                                    ``(I) The individual's name.
                                    ``(II) The individual's date of 
                                birth.
                                    ``(III) The individual's sex.
                                    ``(IV) The individual's social 
                                security insurance number.
                                    ``(V) The number assigned by the 
                                Secretary to the individual for claims 
                                under this title.
                                    ``(VI) The family relationship of 
                                the individual to the person who has 
                                current or prior employment status with 
                                the employer.
                            ``(ii) Elements concerning the family 
                        member with current or prior employment 
                        status.--
                                    ``(I) The name of the person in the 
                                individual's family who has current or 
                                prior employment status with the 
                                employer.
                                    ``(II) That person's social 
                                security insurance number.
                                    ``(III) The number or other 
                                identifier assigned by the plan to that 
                                person.
                                    ``(IV) The periods of coverage for 
                                that person under the plan.
                                    ``(V) The employment status of that 
                                person (current or former employee) 
                                during those periods of coverage.
                                    ``(VI) The classes (of that 
                                person's family members) covered under 
                                the plan.
                            ``(iii) Plan elements.--
                                    ``(I) The items and services 
                                covered under the plan.
                                    ``(II) The name and address to 
                                which claims under the plan are to be 
                                sent.
                                    ``(III) The name, address, and tax 
                                identification number of the plan 
                                sponsor.
                            ``(iv) Elements concerning the employer.--
                                    ``(I) The employer's name.
                                    ``(II) The employer's address.
                                    ``(III) The employer identification 
                                number of the employer.
                                    ``(IV) The tax identification 
                                number of the employer if different 
                                than the number in clause (iii)(III).
                    ``(D) Use of identifiers.--The administrator of a 
                group health plan shall utilize a unique identifier for 
                the plan in providing information under subparagraph 
                (A) and in other transactions, as may be specified by 
the Secretary, related to the provisions of this subsection. The 
Secretary may provide to the administrator the unique identifier 
described in the preceding sentence.
                    ``(E) Penalty for noncompliance.--Any individual or 
                entity that knowingly and willfully fails to comply 
                with a requirement imposed by this paragraph shall be 
                subject to a civil money penalty not to exceed $1,000 
                for each incident of such failure. The provisions of 
                section 1128A (other than subsections (a) and (b)) 
                shall apply to a civil money penalty under the previous 
                sentence in the same manner as those provisions apply 
                to a penalty or proceeding under section 1128A(a).
                    ``(F) Group health plan defined.--In this 
                paragraph, the term `group health plan' has the meaning 
                given such term in paragraph (1)(A)(v).''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect on January 1, 2000.

SEC. 126. EXTENSION OF SUBPOENA AND INJUNCTION AUTHORITY.

    (a) Subpoena Authority.--Section 1128A(j)(1) of the Social Security 
Act (42 U.S.C. 1320a-7a(j)(1)) is amended by inserting ``and section 
1128'' after ``with respect to this section''.
    (b) Injunction Authority.--Section 1128A(k) of the Social Security 
Act (42 U.S.C. 1320a-7a(k)) is amended by inserting ``or an exclusion 
under section 1128,'' after ``subject to a civil monetary penalty under 
this section,''.
    (c) Clarifying Amendments.--
            (1) In general.--Section 1128A(j)(1) of the Social Security 
        Act (42 U.S.C. 1320a-7a(j)(1)) is amended--
                    (A) by inserting ``, except that, in so applying 
                such sections, any reference therein to the 
                Commissioner of Social Security or the Social Security 
                Administration shall be considered a reference to the 
                Secretary or the Department of Health and Human 
                Services, respectively'' after ``with respect to title 
                II''; and
                    (B) by striking the second sentence.
            (2) Authority.--Section 1128A(j)(2) of the Social Security 
        Act (42 U.S.C. 1320a-7a(j)(2)) is amended to read as follows:
    ``(2) The Secretary may delegate to the Inspector General of the 
Department of Health and Human Services any or all authority granted 
under this section or under section 1128.''.
    (d) Conforming Amendment.--Section 1128 of the Social Security Act 
(42 U.S.C. 1320a-7) is amended by adding at the end the following:
    ``(k) For provisions of law concerning the Secretary's subpoena and 
injunction authority with respect to activities under this section, see 
subsections (j) and (k) of section 1128A.''.

SEC. 127. CIVIL MONETARY PENALTIES FOR SERVICES ORDERED OR PRESCRIBED 
              BY AN EXCLUDED INDIVIDUAL OR ENTITY.

    (a) In General.--Section 1128A(a)(1) of the Social Security Act (42 
U.S.C. 1320a-7a(a)(1)) is amended--
            (1) in subparagraph (D)--
                    (A) by inserting ``, ordered, or prescribed by such 
                person'' after ``other item or service furnished'';
                    (B) by inserting ``(pursuant to this title or title 
                XVIII)'' after ``period in which the person was 
                excluded'';
                    (C) by striking ``pursuant to a determination by 
                the Secretary'' and all that follows through ``the 
                provisions of section 1842(j)(2)''; and
                    (D) by striking ``or'' at the end;
            (2) by redesignating subparagraph (E) as subparagraph (F); 
        and
            (3) by adding after subparagraph (D) the following:
                    ``(E) is for a medical or other item or service 
                ordered or prescribed by a person excluded (pursuant to 
                this title or title XVIII) from the program under which 
                the claim was made, and the person furnishing such item 
                or service knows or should know of such exclusion, 
                or''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to claims presented on or after the date of enactment of this 
Act.

SEC. 128. CIVIL MONETARY PENALTIES FOR FALSE CERTIFICATION OF 
              ELIGIBILITY TO RECEIVE PARTIAL HOSPITALIZATION AND 
              HOSPICE SERVICES.

    (a) In General.--Section 1128A(b)(3) of the Social Security Act (42 
U.S.C. 1320a-7a(b)(3)) is amended--
            (1) in subparagraph (A)(ii), by inserting ``, hospice care, 
        or partial hospitalization services'' after ``home health 
        services''; and
            (2) in subparagraph (B), by inserting ``, section 
        1814(a)(7) in the case of hospice care, or section 
        1835(a)(2)(F) in the case of partial hospitalization services'' 
        after ``home health services''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to documents executed on or after the date of enactment of this 
Act.

SEC. 129. APPLICATION OF CERTAIN PROVISIONS OF THE BANKRUPTCY CODE.

    (a) Restricted Applicability of Bankruptcy Stay, Discharge, and 
Preferential Transfer Provisions to Medicare and Medicaid Debts.--Title 
XI of the Social Security Act (42 U.S.C. 1301 et seq.) is amended by 
inserting after section 1143 the following:

       ``application of certain provisions of the bankruptcy code

    ``Sec. 1144. (a) Medicare- and Medicaid-Related Actions Not Stayed 
by Bankruptcy Proceedings.--The commencement or continuation of any 
action against a debtor under this title, title XVIII, or title XIX 
(other than an action with respect to health care services provided to 
the debtor under title XVIII), including any action or proceeding to 
exclude or suspend the debtor from program participation, assess civil 
money penalties, recoup or set off overpayments, or deny or suspend 
payment of claims shall not be subject to the provisions of section 
362(a) of title 11, United States Code.
    ``(b) Medicare- and Medicaid-Related Debt Not Dischargeable in 
Bankruptcy.--A debt owed to the United States or to a State for an 
overpayment under title XVIII or title XIX (other than an overpayment 
for health care services provided to the debtor under title XVIII), or 
for a penalty, fine, or assessment under this title, title XVIII, or 
title XIX, shall not be dischargeable under any provision of title 11, 
United States Code.
    ``(c) Repayment of Certain Debts Considered Final.--Payments made 
to repay a debt to the United States or to a State with respect to 
items or services provided, or claims for payment made, under title 
XVIII or XIX (including repayment of an overpayment (other than an 
overpayment for health care services provided to the debtor under title 
XVIII)), or to pay a penalty, fine, or assessment under this title, 
title XVIII, or title XIX, shall be considered final and not 
preferential transfers under section 547 of title 11, United States 
Code.''.
    (b) Medicare Rules Applicable to Bankruptcy Proceedings.--Title 
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) is amended by 
adding at the end the following:

           ``application of provisions of the bankruptcy code

    ``Sec. 1897. (a) Use of Medicare Standards and Procedures.--
Notwithstanding any provision of title 11, United States Code, or any 
other provision of law, in the case of claims by a debtor in bankruptcy 
for payment under this title, the determination of whether the claim is 
allowable, and of the amount payable, shall be made in accordance with 
the provisions of this title and title XI.
    ``(b) Notice to Creditor of Bankruptcy Petitioner.--In the case of 
a debt owed to the United States with respect to items or services 
provided, or claims for payment made, under this title (including a 
debt arising from an overpayment or a penalty, fine, or assessment 
under title XI or this title), the notices to the creditor of 
bankruptcy petitions, proceedings, and relief required under title 11, 
United States Code (including under section 342 of that title and 
section 2002(j) of the Federal Rules of Bankruptcy Procedure), shall be 
given to the Secretary. Provision of such notice to a fiscal agent of 
the Secretary shall not be considered to satisfy this requirement.
    ``(c) Turnover of Property to the Bankruptcy Estate.--For purposes 
of section 542(b) of title 11, United States Code, a claim for payment 
under this title shall not be considered to be a matured debt payable 
to the estate of a debtor until such claim has been allowed by the 
Secretary in accordance with procedures under this title.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to petitions filed on or after the date of enactment of this Act.

SEC. 130. IMPROVING PRIVATE SECTOR COORDINATION IN COMBATTING HEALTH 
              CARE FRAUD.

    (a) In General.--Title XI of the Social Security Act (42 U.S.C. 
1301 et seq.) is amended by inserting after section 1157 the following:

``improving private sector coordination in combatting health care fraud

    ``Sec. 1157A. (a) In General.--Notwithstanding any other provision 
of law, no health plan (as defined in section 1128C(c)), issuer of a 
health plan, or employee of a health plan shall be held liable in any 
civil action with respect to the provision of information regarding 
suspected health care fraud, including Federal health care offenses (as 
defined in section 24(a) of title 18, United States Code) to an 
applicable individual unless such information is false and the person 
providing it knew, or had reason to believe, that such information was 
false.
    ``(b) Applicable Individual.--In subsection (a), the term 
`applicable individual' means--
            ``(1) a Federal, State, or local law enforcement official 
        responsible for the investigation or prosecution of suspected 
        health care fraud offenses; or
            ``(2) an employee of a health plan or issuer of a health 
        plan.
    ``(c) Attorney's Fees.--Any health plan, issuer of a health plan, 
or employee of a health plan against whom a civil action is brought, 
and who is found to be entitled to immunity from liability by reason of 
this section, shall be entitled to recover reasonable attorney's fees 
and costs from the person who brought the civil action.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect on the date of enactment of this Act.

SEC. 131. FEES FOR AGREEMENTS WITH MEDICARE PROVIDERS AND SUPPLIERS.

    (a) Fees Related to Medicare Provider and Supplier Enrollment and 
Reenrollment.--Section 1866 of the Social Security Act (42 U.S.C. 
1395cc) is amended by adding at the end the following:
    ``(j) Enrollment Procedures and Fees.--
            ``(1) Enrollment of individuals and entities that are not 
        providers of services.--The Secretary may establish a procedure 
        for enrollment (and periodic reenrollment) of individuals or 
        entities that are not providers of services subject to the 
        provisions of subsection (a) but that furnish health care items 
        or services under this title.
            ``(2) Fees.--
                    ``(A) In general.--The Secretary may impose fees 
                for initiation and renewal of provider agreements under 
                subsection (a) and for enrollment and periodic 
                reenrollment of other individuals and entities 
                furnishing health care items or services under this 
                title under paragraph (1), in amounts up to the full 
                amount which the Secretary reasonably estimates to be 
                sufficient to cover the Secretary's costs related to 
                the process for initiating and reviewing such 
                agreements and enrollments.
                    ``(B) Fees credited to special fund in treasury.--
                Fees collected pursuant to this paragraph shall be 
                credited to a special fund of the United States 
                Treasury, and shall remain available until expended, to 
                the extent and in such amounts as provided in advance 
                in appropriations Acts, for necessary expenses for 
                these purposes, including costs of establishing and 
                maintaining procedures and records systems, processing 
                applications, and conducting background 
                investigations.''.
    (b) Clerical Amendment.--The heading of section 1866 of the Social 
Security Act (42 U.S.C. 1395cc) is amended to read as follows:

``agreements with providers of services and enrollment of other persons 
                         furnishing services''.

SEC. 132. INCREASED MEDICARE COMPLIANCE, EDUCATION, AND ASSISTANCE FOR 
              HEALTH CARE PROVIDERS.

    (a) Development of Plan.--Not later than 6 months after the date of 
enactment of this Act, the Secretary of Health and Human Services 
shall, in consultation with health care provider representatives, 
develop and implement a comprehensive plan of activities to--
            (1) maximize health care provider knowledge of medicare 
        program integrity requirements, including anti-fraud and abuse 
        laws and administrative actions;
            (2) assist health care providers with medicare program 
        integrity compliance, including educating such providers 
        regarding compliance activities and procedures of the Health 
        Care Financing Administration and the Inspector General of the 
        Department of Health and Human Services;
            (3) develop improved computer technology for health care 
        providers to both reduce their administrative hassles and 
        facilitate their compliance with medicare program requirements, 
        including physician evaluation and management guidelines; and
            (4) otherwise improve compliance among health care 
        providers with rules and regulations under the medicare 
        program.
    (b) Funding.--Notwithstanding any other provision of law, of the 
amounts appropriated under section 1817(k)(4) of the Social Security 
Act (42 U.S.C. 1395i(k)(4)) for a fiscal year, there shall be made 
available $10,000,000 in fiscal year 2000 and such sums as are 
necessary in fiscal years 2001 through 2004 to carry out the purposes 
of this section.

SEC. 133. PAPERWORK AND ADMINISTRATIVE HASSLE REDUCTION.

    (a) Study by Committee.--
            (1) Establishment.--Not later than 90 days after the date 
        of enactment of this Act, the Secretary of Health and Human 
        Services shall contract with the Institute of Medicine of the 
        National Academy of Sciences to establish a committee to study 
        medicare program administrative requirements that are 
        applicable to health care providers under such program.
            (2) Committee.--The committee described in paragraph (1) 
        shall be composed of--
                    (A) at least 9 health care providers who 
                participate in, and have significant experience working 
                with, the medicare program;
                    (B) experts in paperwork reduction; and
                    (C) beneficiaries under the medicare program or 
                their representatives.
    (b) Recommendations.--The committee described in subsection (a) 
shall develop recommendations regarding how paperwork and 
administrative requirements under the medicare program can be minimized 
in a manner that--
            (1) increases the time health care providers that are 
        subject to such requirements have to spend in direct patient 
        care; and
            (2) maintains medicare program integrity and compliance 
        with anti-fraud and abuse requirements.
In developing such recommendations, the committee shall seek to 
streamline variations in administrative and paperwork requirements 
between the medicare program and other government health programs and 
private health plans.
    (c) Report.--
            (1) In general.--Not later than June 1, 2000, the committee 
        described in subsection (a) shall submit a report to the 
        Secretary of Health and Human Services, the Committees on 
        Finance and Appropriations of the Senate and the Committees on 
        Ways and Means, Commerce, and Appropriations of the House of 
        Representatives.
            (2) Contents.--The report required under paragraph (1) 
        shall contain a detailed description of the matters studied 
        pursuant to subsection (a) and the recommendations developed 
        pursuant to subsection (b), including such legislation and 
        administrative actions as the committee considers appropriate.
    (d) Authorization of Appropriations.--
            (1) In general.--There are authorized to be appropriated 
        $1,000,000 for fiscal year 2000 to carry out the purposes of 
        this section.
            (2) Availability.--Any sums appropriated under the 
        authorization contained in this subsection shall remain 
        available, without fiscal year limitation, until expended.

SEC. 134. CLARIFICATION OF APPLICATION OF SANCTIONS TO FEDERAL HEALTH 
              CARE PROGRAMS.

    (a) Coverage of Employment.--Section 1128 of the Social Security 
Act (42 U.S.C. 1320a-7) is amended--
            (1) in subsection (a), in the matter preceding paragraph 
        (1), by inserting ``(including employment under)'' after 
        ``participation in''; and
            (2) in subsection (b), in the matter preceding paragraph 
        (1), by inserting ``(including employment under)'' after 
        ``participation in''.
    (b) Application Under Civil Money Penalty Authority.--Section 1128A 
of the Social Security Act (42 U.S.C. 1320a-7a) is amended--
            (1) in subsection (a)(4), by striking ``program under title 
        XVIII or a State health care program'' and inserting ``Federal 
        health care program'' each place it appears;
            (2) in subsection (a)(5)--
                    (A) by striking ``title XVIII of this Act, or under 
                a State health care program (as defined in section 
                1128(h))'' and inserting ``a Federal health care 
                program''; and
                    (B) by striking ``title XVIII, or a State health 
                care program (as so defined)'' and inserting ``such 
                program'';
            (3) in the last sentence of subsection (a), by striking 
        ``and to direct the appropriate State agency to exclude the 
        person from participation in any State health care program''; 
        and
            (4) in subsection (h), by striking ``State agency or 
        agencies administering or supervising the administration of 
        State health care programs (as defined in section 1128(h))'' 
        and inserting ``Federal or State agency or agencies 
        administering or supervising the administration of any Federal 
        health care program''.
    (c) Application of Waiver Provisions to Federal Health Care 
Programs.--Section 1128 of the Social Security Act (42 U.S.C. 1320a-7) 
is amended--
            (1) in subsection (c)(3)(B), by striking ``upon the request 
        of a State'' and inserting ``upon the request of the director 
        of a Federal health care program'';
            (2) in subsection (d)(3)(B)(i)--
                    (A) by striking ``State health care program'' and 
                inserting ``Federal health care program''; and
                    (B) by striking ``State agency'' and inserting 
                ``Federal or State agency''; and
            (3) in subsection (d)(3)(B)(ii), by striking ``State health 
        care program'' and inserting ``Federal health care program 
        (other than under title XVIII)''.
    (d) Notice Provision Regarding Federal Health Care Programs.--
Section 1128 of the Social Security Act (42 U.S.C. 1320a-7) is 
amended--
            (1) in the heading of subsection (d), by striking ``to 
        State Agencies and Exclusion Under State Health Care 
Programs'' and inserting ``and Exclusion Under Federal Health Care 
Programs'';
            (2) in subsection (d)(1), by striking ``State'' and 
        inserting ``Federal'';
            (3) in subsection (d)(2)--
                    (A) by striking ``State agency'' and inserting 
                ``Federal or State agency'' each place it appears; and
                    (B) by striking ``State health care program'' and 
                inserting ``Federal health care program'' each place it 
                appears;
            (4) in subsection (d)(3)(A), by striking ``State'' and 
        inserting ``Federal''; and
            (5) in subsection (g)(3)--
                    (A) by striking ``State agency'' and inserting 
                ``Federal or State agency''; and
                    (B) by striking ``State health care program'' and 
                inserting ``Federal health care program''.
    (e) Use of Definition of Federal Health Care Program and Treatment 
of Federal Employees Health Benefits Program as a Federal Health Care 
Program.--Section 1128B(f) of the Social Security Act (42 U.S.C. 1320a-
7b(f)) is amended--
            (1) in the matter preceding paragraph (1), by inserting 
        ``and sections 1128 and 1128A'' after ``this section''; and
            (2) in paragraph (1), by striking ``(other than the health 
        insurance program under chapter 89 of title 5, United States 
        Code)''.
    (f) Authority To Exclude From Federal Health Care Programs Based on 
PRO Recommendations.--Section 1156(b)(1) of the Social Security Act (42 
U.S.C. 1320c-5(b)(1)) is amended--
            (1) in the second sentence, by striking ``eligibility to 
        provide services under this Act on a reimbursable basis'' and 
        inserting ``participation in any Federal health care program 
        (as defined in section 1128B(f))''; and
            (2) in the third sentence, by striking ``eligibility to 
        provide services on a reimbursable basis'' and inserting 
        ``participation in such programs''.
    (g) Effective Date.--
            (1) In general.--Subject to paragraph (2), the amendments 
        made by this section shall take effect on the date of enactment 
        of this Act.
            (2) Convictions under fehbp.--The amendment made by 
        subsection (e)(2) shall apply, with respect to convictions 
        under the health insurance program under chapter 89 of title 5, 
        United States Code, to convictions that occur on or after the 
        date of enactment of this Act.

SEC. 135. PAYMENTS FOR DURABLE MEDICAL EQUIPMENT.

    (a) In General.--Section 1834(a)(1) of the Social Security Act (42 
U.S.C. 1395m(a)(1)) is amended--
            (1) in subparagraph (B)--
                    (A) in clause (i), by striking ``, or'' at the end 
                and inserting a semicolon; and
                    (B) by inserting after clause (ii) the following:
                            ``(iii) the least expensive amount that the 
                        supplier of the item is paid by a 
                        Medicare+Choice organization for such item; or
                            ``(iv) the least expensive amount that the 
                        supplier of the item is paid by any Federal 
                        health care program (as defined in section 
                        1128B(f)) for such item;''; and
            (2) by adding at the end the following:
                    ``(E) Administrative costs.--
                            ``(i) In general.--Except as provided in 
                        clause (ii), if--
                                    ``(I) the payment amount for an 
                                item is covered under clauses (iii) or 
                                (iv) of subparagraph (B); and
                                    ``(II) the Secretary determines 
                                that the administrative costs 
                                associated with billing and receiving 
                                reimbursement from the Secretary for 
                                the item exceeds the administrative 
                                costs associated with providing such 
                                item to a Medicare+Choice organization 
                                or another Federal health care program 
                                (as so defined);
                        then the Secretary shall adjust the payment 
                        rate for such item to reflect such excess.
                            ``(ii) Limitation.--In no case may the 
                        payment rate for an item that is adjusted under 
                        clause (i) exceed the payment rate for such 
                        item determined in clauses (i) and (ii) of 
                        subparagraph (B).
                            ``(iii) Collection of information.--The 
                        Secretary shall collect from durable medical 
                        equipment suppliers that receive reimbursement 
                        under Federal health care programs (as so 
                        defined) such information as the Secretary 
                        determines is necessary in order to make the 
                        determination described in clause (i)(II).''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to items provided on or after January 1, 2000.

SEC. 136. IMPLEMENTATION OF COMMERCIAL CLAIMS AUDITING SYSTEMS.

    (a) Commercial Claims Auditing Systems.--
            (1) In general.--Not later than 90 days after the date of 
        enactment of this Act, the Secretary shall require medicare 
        carriers to use commercial claims auditing systems in the 
        processing of claims under part B of the medicare program under 
        title XVIII of the Social Security Act (42 U.S.C. 1395j et 
        seq.) for the purpose of identifying billing errors and abuses.
            (2) Supplement to other technology.--Commercial claims 
        auditing systems required under paragraph (1) shall be used as 
        a supplement to any other information technology used by 
        medicare carriers in processing claims under the medicare 
        program.
            (3) Uniformity.--In order to ensure uniformity in 
        processing claims under the medicare program, the Secretary may 
        require that medicare carriers utilize 1 or more common 
        commercial claims auditing systems, provided that the selection 
        of such system or systems by the Secretary shall be--
                    (A) after due consideration of competing 
                alternative systems; but
                    (B) without regard to any provision of law that 
                requires the use of competitive procedures (as defined 
                in section 4 of the Office of Federal Procurement 
                Policy Act (41 U.S.C. 403)) or the publication of 
                notice of proposed procurements.
            (4) Implementation.--Commercial claims auditing systems 
        required under paragraph (1) shall be implemented by all 
        medicare carriers by not later than 180 days after the date of 
        enactment of this Act.
    (b) Minimum Software Requirements.--Any commercial claims auditing 
system required to be implemented pursuant to subsection (a) shall, at 
a minimum--
            (1) be a commercial item;
            (2) surpass the capability of systems currently used in the 
        processing of claims under part B of the medicare program; and
            (3) be modifiable to--
                    (A) satisfy pertinent statutory requirements of the 
                medicare program; and
                    (B) conform to policies of the Secretary regarding 
                claims processing under such program.
    (c) Disclosure.--
            (1) In general.--Except as provided in paragraph (2), 
        notwithstanding any other provision of law, any information 
        technology (or data related thereto) utilized by medicare 
        carriers in establishing a commercial claims auditing system 
        pursuant to subsection (a) shall not be subject to public 
        disclosure.
            (2) Authorized disclosure.--The Secretary may authorize the 
        public disclosure of the information described in paragraph (1) 
        if the Secretary determines that--
                    (A) release of such information is in the public 
                interest; and
                    (B) the information to be released is not protected 
                from disclosure under section 552(b) of title 5, United 
                States Code.
    (d) Definitions.--In this section--
            (1) Commercial claims auditing system.--The term 
        ``commercial claims auditing system'' means a commercial 
        specialized auditing system that includes edits which identify 
        inappropriately coded health care claims.
            (2) Commercial item.--The term ``commercial item'' has the 
        meaning given such term in section 4 of the Office of Federal 
        Procurement Policy Act (41 U.S.C. 403).
            (3) Information technology.--The term ``information 
        technology'' has the meaning given such term in subparagraphs 
        (A) and (B) of section 5002(3) of the Information Technology 
        Management Reform Act of 1996 (40 U.S.C. 1401(3)), were such 
        information technology to be acquired by an executive agency.
            (4) Medicare carrier.--The term ``medicare carrier'' means 
        an entity that has a contract with the Secretary pursuant to 
        section 1842(a) of the Social Security Act (42 U.S.C. 
        1395u(a)).
            (5) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.

SEC. 137. PARTIAL HOSPITALIZATION PAYMENT REFORMS.

    (a) Limitation on Location of Provision of Services.--
            (1) In general.--Section 1861(ff)(2) of the Social Security 
        Act (42 U.S.C. 1395x(ff)(2)) is amended in the matter following 
        subparagraph (I)--
                    (A) by striking ``and furnished'' and inserting 
                ``furnished''; and
                    (B) by inserting ``, and furnished other than in a 
                skilled nursing facility or in an individual's personal 
                residence'' before the period.
            (2) Effective date.--The amendments made by paragraph (1) 
        shall apply to partial hospitalization services furnished on or 
        after the first day of the third month beginning after the date 
        of enactment of this Act.
    (b) Qualifications for Community Mental Health Centers.--Section 
1861(ff)(3)(B) of the Social Security Act (42 U.S.C. 1395x(ff)(3)(B)) 
is amended by striking ``entity'' and all that follows and inserting 
the following: ``entity that--
            ``(i) provides the mental health services described in 
        paragraph (1) of section 1913(c) of the Public Health Service 
        Act;
            ``(ii) meets applicable licensing or certification 
        requirements for community mental health centers in the State 
        in which it is located; and
            ``(iii) meets such additional standards or requirements as 
        the Secretary may specify to ensure--
                    ``(I) the health and safety of individuals being 
                furnished such services;
                    ``(II) the effective or efficient furnishing of 
                such services (including protecting against fraud, 
                waste, and abuse); and
                    ``(III) the compliance of such entity with the 
                criteria described in such section.''.
    (c) Reenrollment of Providers of CMHC Partial Hospitalization 
Services.--
            (1) In general.--With respect to each community mental 
        health center that furnishes partial hospitalization services 
        for which payment is made under title XVIII of the Social 
        Security Act, the Secretary of Health and Human Services shall 
        provide for periodic recertification to ensure that the 
        provision of such services complies with section 1913(c) of the 
        Public Health Service Act.
            (2) Deadline for first recertification.--The first 
        recertification under paragraph (1) shall be completed not 
        later than 1 year after the date of enactment of this Act.
    (d) Prospective Payment System for Partial Hospitalization 
Services.--
            (1) Establishment of system.--Section 1833 of the Social 
        Security Act (42 U.S.C. 1395l) is amended by inserting after 
        subsection (o) the following:
    ``(p)(1) The Secretary may establish by regulation a prospective 
payment system for partial hospitalization services provided by a 
community mental health center or by a hospital to its outpatients. The 
system shall provide for appropriate payment levels for efficient 
centers and hospitals and take into account payment levels for similar 
services furnished by other efficient entities.
    ``(2) A prospective payment system established pursuant to 
paragraph (1) shall provide for payment amounts for--
            ``(A) the first year in which such system applies, at a 
        level so that, as estimated by the Secretary, the total 
        aggregate payments under this part (including payments 
        attributable to deductibles and coinsurance) for such year are 
        not greater than the total aggregate payments that would have 
        otherwise been made under this part if such system had not been 
        implemented (assuming full implementation of the provisions 
        contained in subsections (a) through (c) of section 17 of the 
        Medicare Waste Tax Reduction Act of 1999); and
            ``(B) each subsequent year, in an amount equal to the 
        payment amount provided for under this paragraph for the 
        preceding year updated by the percentage increase in the 
        Consumer Price Index for all urban consumers (all items; United 
        States city average) for the 12-month period ending with 
        September of that preceding year.''.
            (2) Coinsurance.--Section 1866(a)(2)(A) of the Social 
        Security Act (42 U.S.C. 1395cc(a)(2)(A)) is amended by adding 
        at the end the following: ``In the case of services described 
        in section 1832(a)(2)(J), clause (ii) of the first sentence of 
        this subparagraph shall be applied by substituting the payment 
        basis established under section 1833(p) for the reasonable 
        charges.''.
            (3) Conforming amendments.--
                    (A) Section 1832(a)(2) of the Social Security Act 
                (42 U.S.C. 1395k(a)(2)) is amended--
                            (i) in subparagraph (B), by striking ``or 
                        subparagraph (I)'' and inserting ``, (I), or 
                        (J)''; and
                            (ii) in subparagraph (J), by striking 
                        ``provided by a community mental health center 
                        (as described in section 1861(ff)(2)(B))''.
                    (B) Section 1833(a) of the Social Security Act (42 
                U.S.C. 1395l(a)) is amended--
                            (i) in paragraph (2) in the matter 
                        preceding subparagraph (A), by striking ``(H), 
                        and (I)'' and inserting ``(H), (I), and (J)'';
                            (ii) in paragraph (8), by striking ``and'' 
                        at the end;
                            (iii) in paragraph (9), by striking the 
                        period at the end and inserting ``; and''; and
                            (iv) by adding at the end the following:
            ``(10) in the case of partial hospitalization services, 80 
        percent of the payment basis under the prospective payment 
        system established under section 1833(p).''.
            (4) Effective date.--The amendments made by paragraphs (2) 
        and (3) apply to services furnished on or after January 1 of 
        the first year that begins at least 6 months after the date on 
        which regulations are issued under section 1833(p) of the 
        Social Security Act (42 U.S.C. 1395l(p)) (as inserted by 
        paragraph (1)).

SEC. 138. EXPANSION OF MEDICARE SENIOR WASTE PATROL NATIONWIDE.

    There are authorized to be appropriated $25,000,000 in fiscal year 
2000, and such sums as are necessary for fiscal years 2001 through 
2003, for the purpose of carrying out, and expanding nationwide, the 
Health Care Anti-Fraud, Waste and Abuse Community Volunteer 
Demonstration Projects conducted by the Administration on Aging 
pursuant to the Omnibus Consolidated Appropriations Act, 1997 (Public 
Law 104-208).

SEC. 139. APPLICATION OF INHERENT REASONABLENESS TO ALL PART B SERVICES 
              OTHER THAN PHYSICIANS' SERVICES.

    (a) Repeal of Certain Provisions of the Balanced Budget Act of 
1997.--
            (1) Repeal.--Section 4316 of the Balanced Budget Act of 
        1997 (Public Law 105-33; 111 Stat. 390), and the amendments 
        made by such section, are repealed effective August 5, 1997.
            (2) Applicability.--Effective August 5, 1997, the Social 
        Security Act shall be applied and administered as if section 
        4316 of the Balanced Budget Act of 1997 (Public Law 105-33; 111 
        Stat. 390), and the amendments made by such section, had not 
        been enacted.
    (b) Application of Inherent Reasonableness to All Part B Services 
Other Than Physicians' Services.--
            (1) In general.--Section 1842(b)(8) of the Social Security 
        Act (42 U.S.C. 1395u(b)(8)) is amended to read as follows:
    ``(8) The Secretary shall describe by regulation the factors to be 
used in determining the cases (of particular items or services) in 
which the application of this part (other than to physicians' services 
paid under section 1848) results in the determination of an amount 
that, because of its being grossly excessive or grossly deficient, is 
not inherently reasonable, and provide in those cases for the factors 
to be considered in establishing an amount that is realistic and 
equitable.''.
            (2) Effective date.--The amendment made by this subsection 
        shall take effect August 5, 1997.

SEC. 140. STANDARDS REGARDING PAYMENT FOR CERTAIN ORTHOTICS AND 
              PROSTHETICS.

    (a) Standards.--
            (1) In general.--Section 1834(h)(1) of the Social Security 
        Act (42 U.S.C. 1395m(h)(1)) is amended by adding at the end the 
        following:
                    ``(F) Establishment of standards for certain 
                items.--
                            ``(i) In general.--No payment shall be made 
                        for an applicable item unless such item is 
                        provided by a qualified practitioner or a 
                        qualified supplier under the system established 
                        by the Secretary under clause (iii). For 
                        purposes of the preceding sentence, if a 
                        qualified practitioner or a qualified supplier 
                        contracts with an entity to provide an 
                        applicable item, then no payment shall be made 
                        for such item unless the entity is also a 
                        qualified supplier.
                            ``(ii) Definitions.--In this subparagraph--
                                    ``(I) Applicable item.--The term 
                                `applicable item' means orthotics and 
                                prosthetics that require education, 
                                training, and experience to custom 
                                fabricate such item. Such term does not 
                                include shoes and shoe inserts.
                                    ``(II) Qualified practitioner.--The 
                                term `qualified practitioner' means a 
                                physician or health professional who--
                                            ``(aa) is specifically 
                                        trained and educated to provide 
                                        or manage the provision of 
                                        custom-designed, fabricated, 
                                        modified, and fitted orthotics 
                                        and prosthetics, and is either 
                                        certified by the American Board 
                                        for Certification in Orthotics 
                                        and Prosthetics, Inc., or is 
                                        credentialed and approved by a 
                                        program that the Secretary 
                                        determines, in consultation 
                                        with appropriate experts in 
                                        orthotics and prosthetics, has 
                                        training and education 
                                        standards that are necessary to 
                                        provide applicable items;
                                            ``(bb) is licensed in 
                                        orthotics or prosthetics by the 
                                        State in which the applicable 
                                        item is supplied; or
                                            ``(cc) has completed at 
                                        least 10 years practice in the 
                                        provision of applicable items.
                                    ``(III) Qualified supplier.--The 
                                term `qualified supplier' means any 
                                entity that is--
                                            ``(aa) accredited by the 
                                        American Board for 
                                        Certification in Orthotics and 
                                        Prosthetics, Inc.; or
                                            ``(bb) accredited and 
                                        approved by a program that the 
                                        Secretary determines has 
                                        accreditation and approval 
                                        standards that are essentially 
                                        equivalent to those of such 
                                        Board.
                            ``(iii) System.--The Secretary, in 
                        consultation with appropriate experts in 
                        orthotics and prosthetics, shall establish a 
                        system under which the Secretary shall--
                                    ``(I) determine which items are 
                                applicable items and formulate a list 
                                of such items;
                                    ``(II) review the applicable items 
                                billed under the coding system 
                                established under this title; and
                                    ``(III) limit payment for 
                                applicable items pursuant to clause 
                                (i).''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall apply to items provided on or after January 1, 2000.
    (b) Revision of Definition of Orthotics.--
            (1) In general.--Section 1861(s)(9) of the Social Security 
        Act (42 U.S.C. 1395x(s)(9)) is amended by inserting 
        ``(including such braces that are used in conjunction with, or 
        as components of, other medical or non-medical equipment when 
        provided by a qualified practitioner (as defined in subclause 
        (II) of section 1834(h)(1)(F))) or a qualified supplier (as 
        defined in subclause (III) of such section)'' after ``braces''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall apply to items provided on or after January 1, 2000.

SEC. 141. INCREASED FLEXIBILITY IN CONTRACTING FOR MEDICARE CLAIMS 
              PROCESSING.

    (a) Carriers To Include Entities That Are Not Insurance 
Companies.--Section 1842 of the Social Security Act (42 U.S.C. 1395u) 
is amended--
            (1) in subsection (a), in the matter preceding paragraph 
        (1), by striking ``with carriers'' and inserting ``with 
        agencies and organizations (in this section referred to as 
        `carriers')''; and
            (2) by striking subsection (f).
    (b) Secretarial Flexibility in Contracting for and in Assigning 
Fiscal Intermediary and Carrier Functions.--
            (1) In general.--
                    (A) Section 1816(a) of the Social Security Act (42 
                U.S.C. 1395h(a)) is amended to read as follows:
    ``(a)(1) The Secretary may enter into contracts with agencies or 
organizations to perform any or all of the following functions, or 
parts of those functions (or, to the extent provided in a contract, to 
secure performance thereof by other organizations) to--
            ``(A) determine (subject to the provisions of section 1878 
        and to such review by the Secretary as may be provided for by 
        the contracts) the amount of the payments required pursuant to 
        this part to be made to providers of services;
            ``(B) make payments described in subparagraph (A);
            ``(C) provide consultative services to institutions or 
        agencies to enable them to establish and maintain fiscal 
        records necessary for purposes of this part and otherwise to 
        qualify as providers of services;
            ``(D) serve as a center for, and communicate to individuals 
        entitled to benefits under this part and to providers of 
        services, any information or instructions furnished to the 
        agency or organization by the Secretary, and serve as a channel 
        of communication from individuals entitled to benefits under 
        this part and from providers of services to the Secretary;
            ``(E) make such audits of the records of providers of 
        services as may be necessary to ensure that proper payments are 
        made under this part;
            ``(F) perform the functions described by subsection (d); 
        and
            ``(G) perform such other functions as are necessary to 
        carry out the purposes of this part.
    ``(2) As used in this title and title XI, the term `fiscal 
intermediary' means an agency or organization with a contract under 
this section.''.
                    (B) Section 1816(b)(1)(A) of the Social Security 
                Act (42 U.S.C. 1395h(b)(1)(A)) is amended by striking 
                ``after applying the standards, criteria, and 
                procedures'' and inserting ``after evaluating the 
                ability of the agency or organization to fulfill the 
                contract performance requirements''.
                    (C) Section 1816(d) of the Social Security Act (42 
                U.S.C. 1395h(d)) is amended to read as follows:
    ``(d) Each provider of services shall have a fiscal intermediary 
that--
            ``(1) acts as a single point of contact for the provider of 
        services under this part;
            ``(2) makes its services sufficiently available to meet the 
        needs of the provider of services; and
            ``(3) is responsible and accountable for arranging the 
        resolution of issues raised under this part by the provider of 
        services.''.
                    (D) Section 1816(e) of the Social Security Act (42 
                U.S.C. 1395h(d)) is amended to read as follows:
    ``(e) The Secretary, in evaluating the performance of a fiscal 
intermediary, may solicit comments from providers of services.''.
                    (E) Section 1816(f)(1) of the Social Security Act 
                (42 U.S.C. 1395h(f)(1)) is amended to read as follows:
    ``(f)(1) With respect to performance requirements under subsection 
(a), the Secretary may consult with--
            ``(A) Medicare+Choice organizations under part C of this 
        title;
            ``(B) providers of services and other persons who furnish 
        items or services for which payment may be made under this 
        title; and
            ``(C) organizations and agencies performing functions 
        necessary to carry out the purposes of this part.''.
                    (F) Section 1842(b)(2) of the Social Security Act 
                (42 U.S.C. 1395u(b)(2)) is amended--
                            (i) in subparagraph (A)--
                                    (I) by inserting ``(i)'' before 
                                ``No such contract'';
                                    (II) by striking the second 
                                sentence and inserting the following:
    ``(ii) With respect to performance requirements for contracts under 
subsection (a), the Secretary may consult with--
            ``(I) Medicare+Choice organizations under part C of this 
        title;
            ``(II) providers of services and other persons who furnish 
        items or services for which payment may be made under this 
        title; and
            ``(III) organizations and agencies performing functions 
        necessary to carry out the purposes of this part.'';
                                    (III) by striking the third 
                                sentence; and
                                    (IV) by striking the fourth 
                                sentence and inserting the following:
    ``(iii) The Secretary may not require, as a condition of entering 
into a contract under this section or under section 1871, that a 
carrier match data obtained other than in its activities under this 
part with data used in the administration of this part for purposes of 
identifying situations in which section 1862(b) may apply.'';
                            (ii) in subparagraph (B), in the matter 
                        preceding clause (i), by striking ``establish 
                        standards'' and inserting ``develop contract 
                        performance requirements''; and
                            (iii) in subparagraph (D), by striking 
                        ``standards and criteria'' each place it 
                        appears and inserting ``contract performance 
                        requirements''.
            (2) Conforming amendments.--
                    (A) Section 1816(b) of the Social Security Act (42 
                U.S.C. 1395h(b)) is amended--
                            (i) in the matter preceding paragraph (1), 
                        by striking ``an agreement'' and inserting ``a 
                        contract'';
                            (ii) in paragraph (1)(B), by striking 
                        ``agreement'' and inserting ``contract''; and
                            (iii) in paragraph (2)(A), by striking 
                        ``agreement'' and inserting ``contract''.
                    (B) Section 1816(c) of the Social Security Act (42 
                U.S.C. 1395h(c)) is amended--
                            (i) in paragraph (1)--
                                    (I) in the first sentence, by 
                                striking ``An agreement'' and inserting 
                                ``A contract''; and
                                    (II) in the last sentence, by 
                                striking ``an agreement'' and inserting 
                                ``a contract'';
                            (ii) in paragraph (2)(A), in the matter 
                        preceding clause (i)--
                                    (I) by striking ``agreement'' and 
                                inserting ``contract''; and
                                    (II) by inserting ``that provides 
                                for making payments under this part'' 
                                after ``this section'';
                            (iii) in paragraph (2)(C), by striking 
                        ``hospital, rural primary care hospital, 
                        skilled nursing facility, home health agency, 
                        hospice program, comprehensive outpatient 
                        rehabilitation facility, or rehabilitation 
                        agency'' and inserting ``provider of services 
                        (as defined in section 1861(u))''; and
                            (iv) in paragraph (3)(A)--
                                    (I) by striking ``agreement'' and 
                                inserting ``contract''; and
                                    (II) by inserting ``that provides 
                                for making payments under this part'' 
                                after ``this section''.
                    (C) Section 1816(h) of the Social Security Act (42 
                U.S.C. 1395h(h)) is amended--
                            (i) by striking ``An agreement'' and 
                        inserting ``A contract''; and
                            (ii) by striking ``the agreement'' each 
                        place it appears and inserting ``the 
                        contract''.
                    (D) Section 1816(i)(1) of the Social Security Act 
                (42 U.S.C. 1395h(i)(1)) is amended by striking ``an 
                agreement'' and inserting ``a contract''.
                    (E) Section 1816(j) of the Social Security Act (42 
                U.S.C. 1395h(j)) is amended in the matter preceding 
                paragraph (1)--
                            (i) by striking ``An agreement'' and 
                        inserting ``A contract''; and
                            (ii) by striking ``for home health 
                        services, extended care services, or post-
                        hospital extended care services''.
                    (F) Section 1816(k) of the Social Security Act (42 
                U.S.C. 1395h(k)) is amended--
                            (i) by striking ``An agreement'' and 
                        inserting ``A contract''; and
                            (ii) by inserting ``(as appropriate)'' 
                        after ``submit''.
                    (G) Section 1816(l) of the Social Security Act (42 
                U.S.C. 1395h(l)) is amended by striking ``an 
                agreement'' and inserting ``a contract''.
                    (H) Section 1842(a) of the Social Security Act (42 
                U.S.C. 1395u(a)) is amended--
                            (i) in the matter preceding paragraph (1) 
                        (as amended by subsection (a)(1))--
                                    (I) by striking ``carriers with 
                                which agreements'' and inserting 
                                ``single contracts under section 1816 
                                and this section together, or separate 
                                contracts with eligible agencies and 
                                organizations with which contracts''; 
                                and
                                    (II) by striking ``some or all of 
                                the following functions'' and inserting 
                                ``any or all of the following 
                                functions, or parts of those 
                                functions''; and
                            (ii) in paragraph (3), by inserting ``(to 
                        and from individuals enrolled under this part 
                        and to and from physicians and other entities 
                        that furnish items and services)'' after 
                        ``communication''.
                    (I) Section 1842(b) of the Social Security Act (42 
                U.S.C. 1395u(b)(2)(C)) is amended--
                            (i) in paragraph (2)(C), in the first 
                        sentence, by inserting ``(as appropriate)'' 
                        after ``carriers'';
                            (ii) in paragraph (3), in the matter 
                        preceding subparagraph (A), by inserting ``(as 
                        appropriate)'' after ``contract'';
                            (iii) in paragraph (7)(A), in the matter 
                        preceding clause (i), by striking ``the 
                        carrier'' and inserting ``a carrier''; and
                            (iv) in paragraph (11)(A), in the matter 
                        preceding clause (i), by inserting ``(as 
                        appropriate)'' after ``each carrier''.
                    (J) Section 1842(h) of the Social Security Act (42 
                U.S.C. 1395u(h)) is amended--
                            (i) in paragraph (2), in the first 
                        sentence--
                                    (I) by striking ``an agreement'' 
                                and inserting ``a contract''; and
                                    (II) by inserting ``(as 
                                appropriate)'' after ``shall'';
                            (ii) in paragraph (3)(A), by striking ``an 
                        agreement'' and inserting ``a contract'';
                            (iii) in paragraph (3)(B), in the third 
                        sentence, by striking ``agreements'' and 
                        inserting ``contracts'';
                            (iv) in paragraph (5)(A), by inserting 
                        ``(as appropriate)'' after ``carriers''; and
                            (v) in paragraph (8)--
                                    (I) by striking ``an agreement'' 
                                and inserting ``a contract''; and
                                    (II) by striking ``such agreement'' 
                                and inserting ``such contract''.
    (c) Elimination of Special Provisions for Terminations of 
Contracts.--
            (1) Section 1816 of the Social Security Act (42 U.S.C. 
        1395h) is amended--
                    (A) in subsection (b), in the matter preceding 
                paragraph (1), by striking ``or renew'';
                    (B) in subsection (c)(1), in the last sentence, by 
                striking ``or renewing''; and
                    (C) by striking subsection (g).
            (2) Section 1842(b) of the Social Security Act (42 U.S.C. 
        1395u(b)(2)) is amended by striking paragraph (5).
    (d) Repeal of Fiscal Intermediary Requirements That Are Not Cost-
Effective.--Section 1816(f)(2) of the Social Security Act (42 U.S.C. 
1395h(f)(2)) is amended to read as follows:
    ``(2) The contract performance requirements described in paragraph 
(1) shall include--
            ``(A) with respect to claims for services furnished under 
        this part by any provider of services (as defined in section 
        1861(u)) other than a hospital, whether such agency or 
        organization is able to process 75 percent of reconsiderations 
        within 60 days and 90 percent of reconsiderations within 90 
        days; and''.
    (e) Repeal of Cost Reimbursement Requirements.--
            (1) Section 1816(c)(1) of the Social Security Act (42 
        U.S.C. 1395h(c)(1)) is amended--
                    (A) in the first sentence--
                            (i) by striking the comma after 
                        ``appropriate'' and inserting ``and''; and
                            (ii) by striking ``, and shall provide for 
                        payment'' and all that follows before the 
                        period; and
                    (B) by striking the second and third sentences.
            (2) Section 1842(c)(1) of the Social Security Act (42 
        U.S.C. 1395h(c)(1)) is amended--
                    (A) in the first sentence--
                            (i) by striking ``section shall provide'' 
                        and inserting ``section may provide''; and
                            (ii) by striking ``, and shall provide'' 
                        and all that follows before the period; and
                    (B) by striking the second and third sentences.
            (3) Section 2326 of the Deficit Reduction Act of 1984 (42 
        U.S.C. 1395h note) is amended by striking subsection (a).
    (f) Secretarial Flexibility With Respect to Renewing Contracts and 
Transfer of Functions.--
            (1) Section 1816(c) of the Social Security Act (42 U.S.C. 
        1395h(c)) is amended by adding at the end the following:
    ``(4)(A) Except as provided in laws with general applicability to 
Federal acquisition and procurement or in subparagraph (B), the 
Secretary shall use competitive procedures when entering into contracts 
under this section.
    ``(B)(i) The Secretary may renew a contract with a fiscal 
intermediary under this section from term to term without regard to 
section 5 of title 41, United States Code, or any other provision of 
law requiring competition, if the fiscal intermediary has met or 
exceeded the performance requirements established in the current 
contract.
    ``(ii) Functions may be transferred among fiscal intermediaries 
without regard to any provision of law requiring competition. However, 
the Secretary shall ensure that performance quality is considered in 
such transfers.''.
            (2) Section 1842(b)(1) of the Social Security Act (42 
        U.S.C. 1395u(b)(1)) is amended to read as follows:
    ``(b)(1)(A) Except as provided in laws with general applicability 
to Federal acquisition and procurement or in subparagraph (B), the 
Secretary shall use competitive procedures when entering into contracts 
under this section.
    ``(B)(i) The Secretary may renew a contract with a carrier under 
subsection (a) from term to term without regard to section 5 of title 
41, United States Code, or any other provision of law requiring 
competition, if the carrier has met or exceeded the performance 
requirements established in the current contract.
    ``(ii) Functions may be transferred among carriers without regard 
to any provision of law requiring competition. However, the Secretary 
shall ensure that performance quality is considered in such 
transfers.''.
    (g) Year 2000 Compliance.--
            (1) Section 1816(f)(2) of the Social Security Act (42 
        U.S.C. 1395h(f)(2)) (as amended by subsection (d)) is amended 
        by adding at the end the following:
            ``(B) a requirement that, by such time as the Secretary 
        considers reasonable, the information technology that is used 
        or acquired by the agency or organization to carry out its 
        responsibilities under this title (to the extent that the 
        Secretary finds such information technology is under the 
        control of such agency or organization)--
                    ``(i) meets the definition of `Year 2000 compliant' 
                under the Federal Acquisition Regulation (concerning 
                accurate processing of date and time data (including 
                calculating, comparing, and sequencing) from, into, and 
                between the 20th and 21st centuries, and the years 1999 
                and 2000 and leap year calculations) but without regard 
                to whether the information technology is being 
                acquired; and
                    ``(ii) meets such other criteria for Year 2000 
                compliance as the Secretary considers appropriate.''.
            (2) Section 1842(b)(2)(A)(i) of the Social Security Act (42 
        U.S.C. 1395u(b)(2)(A)(i)) (as amended by subsection (b)(1)(F)) 
        is amended by striking the period and inserting ``, including a 
        requirement that, by such time as the Secretary considers 
        reasonable, the information technology that is used or acquired 
        by such carrier to carry out its responsibilities under this 
        title (to the extent that the Secretary finds such information 
        technology is under the control of such carrier) meets--
            ``(I) the definition of `Year 2000 compliant' under the 
        Federal Acquisition Regulation (concerning accurate processing 
        of date and time data (including calculating, comparing, and 
        sequencing) from, into, and between the 20th and 21st 
        centuries, and the years 1999 and 2000 and leap year 
        calculations) but without regard to whether the information 
        technology is being acquired; and
            ``(II) such other criteria for Year 2000 compliance as the 
        Secretary considers appropriate.''.
    (h) Waiver of Competitive Requirements for Initial Contracts.--
Contracts that have periods that begin before or during the 1-year 
period that begins on the first day of the fourth calendar month that 
begins after the date of enactment of this Act may be entered into 
under section 1816(a) or 1842(a) of the Social Security Act (42 U.S.C. 
1395h(a) and 1395u(a)) without regard to any provision of law requiring 
use of competitive procedures.
    (i) Effective Dates.--
            (1) The amendments made by subsection (c) apply to 
        contracts that have periods ending on or after the end of the 
        third calendar month that begins after the date of enactment of 
        this Act.
            (2) The amendments made by subsections (a), (b), (d), and 
        (e) apply to contracts that have periods beginning after the 
        third calendar month that begins after the date of enactment of 
        this Act.
            (3) The amendments made by subsection (f) apply to 
        contracts that have periods that begin after the end of the 1-
        year period specified in paragraph (1) of this subsection.
            (4) The amendment made by subsection (g) shall take effect 
        on the date of enactment of this Act.

               Subtitle D--Reduction in Student Loan Fees

SEC. 151. REDUCTION IN STUDENT LOAN FEES.

    (a) Subsidized Federal Stafford Loans.--Subparagraph (H) of section 
428(b)(1) of the Higher Education Act of 1965 (20 U.S.C. 1078(b)(1)) is 
amended--
            (1) by striking ``not more than''; and
            (2) by striking ``will not be used for incentive payments 
        to lenders'' and inserting ``shall be paid to the Federal 
        Government for deposit in the Treasury''.
    (b) Unsubsidized Stafford Loan and PLUS Loan Insurance Premium 
Redirection.--
            (1) Unsubsidized stafford loans.--Section 428H(h) of the 
        Higher Education Act of 1965 (20 U.S.C. 1078-8(h)) is amended--
                    (A) by striking ``may'' and inserting ``shall'';
                    (B) by striking ``not more than'';
                    (C) by striking ``, if such premium will not be 
                used for incentive payments to lenders''; and
                    (D) by inserting at the end the following: ``The 
                proceeds of the insurance premium shall be paid to the 
                Federal Government for deposit into the Treasury.''.
            (2) PLUS loans.--Section 428B of the Higher Education Act 
        of 1965 (20 U.S.C. 1078-2) is amended by adding after 
        subsection (f) the following:
    ``(g) Insurance Premium.--Each State or nonprofit private 
institution or organization having an agreement with the Secretary 
under section 428(b)(1) shall charge the borrower of a loan made under 
this section a single insurance premium in the amount of 1 percent of 
the principal amount of the loan. The proceeds of the insurance premium 
shall be paid to the Federal Government for deposit into the 
Treasury.''.

   Subtitle E--Limitations on Defense Funding for Fiscal Years 2000 
                              Through 2004

SEC. 161. BUDGET AUTHORITY.

    Notwithstanding any other provision of law, the total amount of the 
budget authority considered as being available for budget function 050 
(National Defense) for fiscal years 2000 through 2004 may not exceed 
the following amounts:
            (1) Fiscal year 2000.--For fiscal year 2000, 
        $276,348,000,000.
            (2) Fiscal year 2001.--For fiscal year 2001, 
        $283,367,000,000.
            (3) Fiscal year 2002.--For fiscal year 2002, 
        $290,470,000,000.
            (4) Fiscal year 2003.--For fiscal year 2003, 
        $297,903,000,000.
            (5) Fiscal year 2004.--For fiscal year 2004, 
        $306,024,000,000.

SEC. 162. PROTECTION OF READINESS AND QUALITY OF LIFE.

    Within the limits set forth in section 161, the amounts available 
for budget function 050 (National Defense) for the fiscal years covered 
by that section shall be expended in a manner that does not adversely 
affect the readiness of the Armed Forces and the quality of life of 
military personnel, military retirees, and their families.

SEC. 163. EXPENDITURES NOT CONSIDERED EMERGENCY EXPENDITURES.

    (a) In General.--Amounts expended for readiness, or for 
peacekeeping operations that began before September 30, 1999, may not 
be considered expenditures for emergency requirements within the 
meaning of section 251(b)(2)(A) of the Balanced Budget and Emergency 
Deficit Control Act of 1985.
    (b) Exception.--The limitation on treatment of expenditures for 
peacekeeping operations under subsection (a) does not apply to 
expenditures for any such operation that significantly increases, in 
terms of the size of the forces involved or in tempo, after September 
30, 1999.

              Subtitle F--Internal Revenue Code Provisions

SEC. 171. RECAPTURE OF UNIFIED CREDIT FOR LARGE ESTATES.

    (a) In General.--Paragraph (2) of section 2001(c) of the Internal 
Revenue Code of 1986 (relating to phaseout of graduated rates and 
unified credit) is amended by striking ``$10,000,000'' and all that 
follows and inserting ``$10,000,000. The amount of the increase under 
the preceding sentence shall not exceed the sum of the applicable 
credit amount under section 2010(c) (determined without regard to 
section 2057(a)(3)) and $359,200.''
    (b) Effective Date.--The amendment made by this section shall apply 
to decedents dying after the date of the enactment of this Act.

SEC. 172. REPEAL OF PERCENTAGE DEPLETION FOR CERTAIN NONFUEL MINERALS 
              MINED ON FEDERAL LANDS.

    (a) In General.--Section 613 of the Internal Revenue Code of 1986 
(relating to percentage depletion) is amended by adding at the end the 
following new subsection:
    ``(f) Denial of Percentage Depletion For Certain Nonfuel Minerals 
Mined on Federal Lands.--
            ``(1) In general.--In the case of any applicable nonfuel 
        mineral, the allowance for depletion shall be computed without 
        reference to this section.
            ``(2) Applicable nonfuel mineral.--For purposes of this 
        subsection, the term `applicable nonfuel mineral' means any 
        mineral which--
                    ``(A) is subject to a mining claim under chapter 
                six of title XXXII of the Revised Statutes (30 U.S.C. 
                21 et seq.) (commonly referred to as the `General 
                Mining Law of 1872'), or
                    ``(B) was originally acquired (whether or not by 
                the taxpayer) pursuant to a patent granted under such 
                chapter.''
    (b) Aggregation of Mineral Interests.--Paragraph (1) of section 
614(c) of the Internal Revenue Code of 1986 (relating to election to 
aggregate separate interests) is amended by adding at the end the 
following new sentence: ``A taxpayer may not elect to aggregate a 
separate operating mineral interest in any applicable nonfuel mineral 
(as defined in section 613(f)(2)) with an interest in a mineral other 
than such an applicable nonfuel mineral.''
    (c) Effective Dates.--
            (1) In general.--The amendments made by this section shall 
        apply to taxable years beginning after the date of the 
        enactment of this Act.
            (2) Special rule for aggregated mineral interests.--
                    (A) In general.--If, on or before the first date on 
                which the Committee on Ways and Means of the House of 
                Representatives or the Committee on Finance of the 
                Senate takes action with respect to such amendments, a 
                taxpayer aggregated separate operating mineral 
                interests in applicable nonfuel minerals (as defined in 
                section 613(f)(2) of the Internal Revenue Code of 1986) 
                and in minerals other than such applicable nonfuel 
                minerals, the amendments made by this section shall not 
                apply to such property, except that the allowance for 
                depletion under section 613 of such Code for taxable 
                years beginning after the date of the enactment of this 
                Act, with respect to such property shall be equal to 
                the amount which bears the same ratio to such allowance 
                computed without regard to this paragraph as the--
                            (i) number of acres in such property with 
                        respect to interests in minerals other than 
                        applicable nonfuel minerals (as so defined), 
                        bears to
                            (ii) total number of acres in such 
                        property.
                    (B) Election to terminate aggregation.--
                Subparagraph (A) shall not apply if a taxpayer elects, 
                at such time and in such manner as the Secretary of the 
                Treasury may prescribe, to terminate the election under 
                section 614(c) of such Code with respect to the 
                property described in subparagraph (A) for all taxable 
                years beginning after the date of the enactment of this 
                Act. In making such election, the taxpayer may elect to 
                aggregate interests in applicable nonfuel minerals and 
                other minerals separately.
            (3) Certain purchases for fair market value.--The 
        amendments made by this section shall not apply with respect to 
any mineral interests in applicable nonfuel minerals (as defined in 
section 613(f)(2) of such Code) acquired by the taxpayer in a sale or 
exchange for fair market value on or before the first day on which the 
Committee on Ways and Means of the House of Representatives or the 
Committee on Finance of the Senate takes action with respect to such 
amendments. The preceding sentence shall not apply if the taxpayer 
acquired such interests after November 10, 1999, and before such first 
date from a person who is a related person (within the meaning of 
section 267 or 707 of such Code).

SEC. 173. REPEAL OF FOREIGN EARNED INCOME EXCLUSION.

    Paragraph (1) of section 911(a) of the Internal Revenue Code of 
1986 (relating to exclusion from gross income) is amended by inserting 
``in the case of taxable years beginning before January 1, 2000,'' 
before ``the foreign earned income''.

SEC. 174. DEPRECIATION ADJUSTMENTS FOR TOBACCO MANUFACTURING EQUIPMENT.

    (a) In General.--Section 168(b)(3) of the Internal Revenue Code of 
1986 (relating to property to which straight line method applies) is 
amended by adding at the end the following new subparagraph:
                            ``(G) Tobacco manufacturing equipment 
                        described in subsection (e)(6).''
    (b) Definition of Tobacco Manufacturing Equipment.--Section 168(e) 
of the Internal Revenue Code of 1986 (relating to classification of 
property) is amended by adding at the end the following new paragraph:
            ``(6) Tobacco manufacturing equipment.--The term `tobacco 
        manufacturing equipment' means property which is used 
        exclusively in the manufacturing or production of tobacco 
        products, other than property which is used in connection with 
        a farming business (as defined in section 263A(e)(4)).''
    (c) Effective Date.--The amendments made by this section shall 
apply to property placed in service after the date of the enactment of 
this Act.

SEC. 175. FOREIGN OIL AND GAS INCOME.

    (a) Special Rules for Foreign Tax Credit With Respect to Foreign 
Oil and Gas Income.--
            (1) Certain taxes not creditable.--
                    (A) In general.--Subsection (a) of section 907 of 
                the Internal Revenue Code of 1986 (relating to 
                reduction in amount allowed as foreign tax under 
                section 901) is amended to read as follows:
    ``(a) Certain Taxes Not Creditable.--
            ``(1) In general.--For purposes of this subtitle, the term 
        `income, war profits, and excess profits taxes' shall not 
        include--
                    ``(A) any taxes which are paid or accrued to any 
                foreign country with respect to foreign oil and gas 
                income and which are not imposed under a generally 
                applicable income tax law of such country, and
                    ``(B) any taxes (not described in subparagraph (A)) 
                which are paid or accrued to any foreign country with 
                respect to foreign oil and gas income to the extent 
                that the foreign law imposing such amount of tax is 
                structured, or in fact operates, so that the amount of 
                tax imposed with respect to foreign oil and gas income 
                will generally be materially greater, over a reasonable 
                period of time, than the amount generally imposed on 
                income that is not foreign oil and gas income.
        In computing the amount not treated as tax under subparagraph 
        (B), such amount shall be treated as a deduction under the 
        foreign law.
            ``(2) Foreign oil and gas income.--For purposes of this 
        paragraph, the term `foreign oil and gas income' means the 
        amount of foreign oil and gas extraction income and foreign oil 
        related income.
            ``(3) Generally applicable income tax law.--For purposes of 
        this paragraph, the term `generally applicable income tax law' 
        means any law of a foreign country imposing an income tax if 
        such tax generally applies to all income from sources within 
        such foreign country--
                    ``(A) without regard to the residence or 
                nationality of the person earning such income, and
                    ``(B) in the case of any income earned by a 
                corporation, partnership, or other entity, without 
                regard to--
                            ``(i) where such corporation, partnership, 
                        or other entity is organized, and
                            ``(ii) the residence or nationality of the 
                        persons owning interests in such corporation, 
                        partnership, or entity.''
                    (B) Conforming amendment.--Section 907 of such Code 
                is amended by striking subsections (b), (c)(3), (c)(4), 
                (c)(5), and (f).
            (2) Separate baskets for foreign oil and gas extraction 
        income and foreign oil related income.--
                    (A) In general.--Paragraph (1) of section 904(d) of 
                such Code (relating to separate application of section 
                with respect to certain categories of income) is 
                amended by striking ``and'' at the end of subparagraph 
                (H), by redesignating subparagraph (I) as subparagraph 
                (K) and by inserting after subparagraph (H) the 
                following new subparagraphs:
                    ``(I) foreign oil and gas extraction income,
                    ``(J) foreign oil related income, and''.
                    (B) Definitions.--Paragraph (2) of section 904(d) 
                of such Code is amended by redesignating subparagraphs 
                (H) and (I) as subparagraphs (J) and (K), respectively, 
                and by inserting after subparagraph (G) the following 
                new subparagraphs:
                    ``(H) Foreign oil and gas extraction income.--The 
                term `foreign oil and gas extraction income' has the 
                meaning given such term by section 907(c)(1). Such term 
                shall not include any dividend from a noncontrolled 
                section 902 corporation.
                    ``(I) Foreign oil related income.--The term 
                `foreign oil related income' has the meaning given such 
                term by section 907(c)(2). Such term shall not include 
                any dividend from a noncontrolled section 902 
                corporation and any shipping income.''
                    (C) Conforming amendment.--Clause (i) of section 
                904(d)(3)(F) of such Code is amended by striking ``or 
                (E)'' and inserting ``(E), (I), or (J)''.
            (3) Effective date.--
                    (A) In general.--Except as otherwise provided in 
                this paragraph, the amendments made by this subsection 
                shall apply to taxable years beginning after December 
                31, 1999.
                    (B) Disallowance rule.--
                            (i) Section 907(a) of such Code (as amended 
                        by paragraph (1)) shall apply to taxes paid or 
                        accrued after December 31, 1999, in taxable 
                        years ending after such date.
                            (ii) In determining the amount of taxes 
                        deemed to be paid in a taxable year beginning 
                        after December 31, 1999, under section 902 or 
                        960 of such Code, section 907(a) of such Code 
(as amended by paragraph (1)) shall apply to all taxes whether paid or 
accrued before, on, or after December 31, 1999.
                    (C) Loss rule.--Notwithstanding the amendments made 
                by paragraph (1)(B), section 907(c)(4) of such Code 
                shall continue to apply with respect to foreign oil and 
                gas extraction losses for taxable years beginning 
                before January 1, 2000.
                    (D) Transitional rules.--
                            (i) Any taxes paid or accrued in a taxable 
                        year beginning before January 1, 2000, with 
                        respect to income which was described in 
                        subparagraph (I) of section 904(d)(1) of such 
                        Code (as in effect on the day before the date 
                        of the enactment of this Act) shall be treated 
                        as taxes paid or accrued with respect to 
                        foreign oil and gas extraction income or 
                        foreign oil related income (as the case may be) 
                        to the extent such taxes were paid or accrued 
with respect to such type of income.
                            (ii) Any unused oil and gas extraction 
                        taxes which under section 907(f) of such Code 
                        (as so in effect) would have been allowed as a 
                        carryover to the taxpayer's first taxable year 
                        beginning after December 31, 1998 (determined 
                        without regard to the limitation of paragraph 
                        (2) of such section 907(f) for such first 
                        taxable year), shall be allowed as carryovers 
                        under section 904(c) of such Code in the same 
                        manner as if they were unused taxes under 
                        section 904(c) with respect to foreign oil and 
                        gas extraction income.
    (b) Elimination of Deferral for Foreign Oil and Gas Extraction 
Income.--
            (1) General rule.--Paragraph (1) of section 954(g) of the 
        Internal Revenue Code of 1986 (defining foreign base company 
        oil related income) is amended to read as follows:
            ``(1) In general.--Except as otherwise provided in this 
        subsection, the term `foreign oil and gas income' means any 
        income of a kind which would be taken into account in 
        determining the amount of--
                    ``(A) foreign oil and gas extraction income (as 
                defined in section 907(c)(1)), or
                    ``(B) foreign oil related income (as defined in 
                section 907(c)(2)).''
            (2) Conforming amendments.--
                    (A)(i) Subsections (a)(5), (b)(5), and (b)(8) of 
                section 954 of such Code are each amended by striking 
                ``base company oil related income'' each place it 
                appears (including in the heading of subsection (b)(8)) 
                and inserting ``oil and gas income''.
                    (ii) Subsection (b)(4) of section 954 of such Code 
                is amended by striking ``base company oil-related 
                income'' and inserting ``oil and gas income''.
                    (B) The subsection heading for subsection (g) of 
                section 954 of such Code is amended by striking 
                ``Foreign Base Company Oil Related Income'' and 
                inserting ``Foreign Oil and Gas Income''.
                    (C) Subparagraph (A) of section 954(g)(2) of such 
                Code is amended by striking ``foreign base company oil 
                related income'' and inserting ``foreign oil and gas 
                income''.
            (3) Effective date.--The amendments made by this subsection 
        shall apply to taxable years of foreign corporations beginning 
        after December 31, 1999, and to taxable years of United States 
        shareholders in which or with which such taxable years of 
        foreign corporations end.

SEC. 176. TRANSFER PRICING.

    (a) Authority of Secretary When Legal Limits on Transfer by 
Taxpayer.--Section 482 of the Internal Revenue Code of 1986 (relating 
to allocation of income and deductions among taxpayers) is amended by 
adding at the end the following: ``The authority of the Secretary under 
this section shall not be limited by any restriction (by any law or 
agreement) on the ability of such interests, organizations, trades, or 
businesses to transfer or receive money or other property.''
    (b) Effective Date.--The amendment made by this section shall apply 
to taxable years beginning after December 31, 1999.

                   TITLE II--MISCELLANEOUS PROVISIONS

SEC. 201. PROHIBITION ON FUNDING TELEVISION MARTI AND RADIO MARTI.

    No Federal funds may be made available to carry out any provision 
of the Television Broadcasting to Cuba Act (22 U.S.C. 14655aa et seq.) 
or the Radio Broadcasting to Cuba Act (22 U.S.C. 1465 et seq.).

SEC. 202. PROHIBITION OF USE OF FEDERAL FUNDS FOR LOBBYING.

    No funds made available for the National Low-Level Radioactive 
Waste Management Program of the Department of Energy may be used to pay 
the costs of lobbying any Federal, State, or local government officer 
or employee on the question of the establishment of a low-level 
radioactive waste storage site at any location.

SEC. 203. PROHIBITION OF FUNDING OF THE NUCLEAR ENERGY RESEARCH 
              INITIATIVE.

    No funds appropriated to the Department of Energy may be used to 
carry out the Nuclear Energy Research Initiative.

SEC. 204. REDUCTION IN GOVERNMENT AGENCY SPENDING ON TRAVEL, PRINTING, 
              SUPPLIES AND OTHER ITEMS.

    Notwithstanding any other provision of law, the total amount of 
budget authority available for a fiscal year to all Federal agencies 
for--
            (1) travel and transportation of persons (object class 
        21.0);
            (2) transportation of things (object class 22.0);
            (3) printing and reproduction (object class 24.0);
            (4) advisory and assistance services (object class 25.1); 
        and
            (5) supplies and materials (object class 26.0);
shall be limited to the actual expenditures for those object classes in 
fiscal year 1998.

SEC. 205. REDUCING STUDENT LOAN DEFAULTS.

    (a) In General.--Section 453(j) of the Social Security Act (42 
U.S.C. 653(j)) is amended by adding at the end the following:
            ``(6) Information comparisons and disclosure for 
        enforcement of obligations on higher education act loans and 
        grants.--
                    ``(A) Furnishing of information by the secretary of 
                education.--The Secretary of Education shall furnish to 
                the Secretary, on a quarterly basis or at such less 
                frequent intervals as may be determined by the 
                Secretary of Education, information in the custody of 
                the Secretary of Education for comparison with 
                information in the National Directory of New Hires, in 
                order to obtain the information in such directory with 
                respect to individuals who--
                            ``(i) are borrowers of loans made under 
                        title IV of the Higher Education Act of 1965 
                        that are in default; or
                            ``(ii) owe an obligation to refund an 
                        overpayment of a grant awarded under such 
                        title.
                    ``(B) Requirement to seek minimum information 
                necessary.--The Secretary of Education shall seek 
                information pursuant to this section only to the extent 
                essential to improving collection of the debt described 
                in subparagraph (A).
                    ``(C) Duties of the secretary.--
                            ``(i) Information comparison; disclosure to 
                        the secretary of education.--The Secretary, in 
                        cooperation with the Secretary of Education, 
                        shall compare information in the National 
                        Directory of New Hires with information in the 
                        custody of the Secretary of Education, and 
                        disclose information in that Directory to the 
                        Secretary of Education, in accordance with this 
                        paragraph, for the purposes specified in this 
                        paragraph.
                            ``(ii) Condition on disclosure.--The 
                        Secretary shall make disclosures in accordance 
                        with clause (i) only to the extent that the 
                        Secretary determines that such disclosures do 
                        not interfere with the effective operation of 
                        the program under this part. Support collection 
                        under section 466(b) shall be given priority 
                        over collection of any defaulted student loan 
                        or grant overpayment against the same income.
                    ``(D) Use of information by the secretary of 
                education.--The Secretary of Education may use 
                information resulting from a data match pursuant to 
                this paragraph only--
                            ``(i) for the purpose of collection of the 
                        debt described in subparagraph (A) owed by an 
                        individual whose annualized wage level 
                        (determined by taking into consideration 
                        information from the National Directory of New 
                        Hires) exceeds $16,000; and
                            ``(ii) after removal of personal 
                        identifiers, to conduct analyses of student 
                        loan defaults.
                    ``(E) Disclosure of information by the secretary of 
                education.--
                            ``(i) Disclosures permitted.--The Secretary 
                        of Education may disclose information resulting 
                        from a data match pursuant to this paragraph 
                        only to--
                                    ``(I) a guaranty agency holding a 
                                loan made under part B of title IV of 
                                the Higher Education Act of 1965 on 
                                which the individual is obligated;
                                    ``(II) a contractor or agent of the 
                                guaranty agency described in subclause 
                                (I);
                                    ``(III) a contractor or agent of 
                                the Secretary; and
                                    ``(IV) the Attorney General.
                            ``(ii) Purpose of disclosure.--The 
                        Secretary of Education may make a disclosure 
                        under clause (i) only for the purpose of 
                        collection of the debts owed on defaulted 
                        student loans, or overpayments of grants, made 
                        under title IV of the Higher Education Act of 
                        1965.
                            ``(iii) Restriction on redisclosure.--An 
                        entity to which information is disclosed under 
                        clause (i) may use or disclose such information 
                        only as needed for the purpose of collecting on 
                        defaulted student loans, or overpayments of 
                        grants, made under title IV of the Higher 
                        Education Act of 1965.
                    ``(F) Reimbursement of hhs costs.--The Secretary of 
                Education shall reimburse the Secretary, in accordance 
                with subsection (k)(3), for the additional costs 
                incurred by the Secretary in furnishing the information 
                requested under this subparagraph.''.
    (b) Penalties for Misuse of Information.--Section 402(a) of the 
Child Support Performance and Incentive Act of 1998 (112 Stat. 669) is 
amended in the matter added by paragraph (2) by inserting ``or any 
other person'' after ``officer or employee of the United States''.
    (c) Effective Date.--The amendments made by this section shall 
become effective October 1, 1999.
                                 <all>