[Congressional Record Volume 143, Number 20 (Monday, February 24, 1997)]
[Senate]
[Pages S1470-S1479]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. THOMAS (for himself and Mr. Robb):
  S. 342. A bill to extend certain privileges, exemptions, and 
immunities to Hong Kong Economic and Trade Offices; to the Committee on 
Foreign Relations.


            HONG KONG ECONOMIC AND TRADE OFFICES LEGISLATION

  Mr. THOMAS. Mr. President, I rise as chairman of the Subcommittee on 
East Asian and Pacific Affairs to introduce S. 342, a bill to extend 
certain privileges, exemptions, and immunities to Hong Kong Economic 
and Trade Offices located in the United States. I am pleased to be 
joined by Senator Robb as an original cosponsor.
  The Hong Kong Government maintains Economic and Trade Offices in 
several countries to represent the Colony's economic and trade 
interests abroad; there are three such Offices in the United States--
San Francisco, New York, and Washington. As my colleagues are aware, at 
midnight on June 30, 1997, Hong Kong will revert to the jurisdiction of 
the People's Republic of China as the Hong Kong Special Administrative 
Region [HKSAR]. The HKSAR will purportedly, under agreements reached 
between the PRC and the United Kingdom, enjoy a high degree of autonomy 
from the central government in Beijing except in the areas of foreign 
policy and defense. That autonomy includes the right to maintain 
economic and trade ties with third countries independent of Beijing.
  The Hong Kong Policy Act of 1992 provided, inter alia, that the 
United States should invite Hong Kong to maintain its Economic and 
Trade Offices after June 30. The reasoning was not only to continue to 
facilitate our trade relationship with our ninth biggest trading 
partner; in addition, the move was meant to underscore our commitment 
to an autonomous Hong Kong after 1997.
  This bill would extend to these offices and employees the provisions 
of the International Organizations Immunities Act and the Agreement on 
State and local Taxation of Foreign Employees of Public International 
Organizations, thereby assuring that these offices are treated in the 
same manner as others similarly situated--such as the Taipei Economic 
and Cultural Representative Offices, Taiwan's representative in the 
United States.
  Identical legislation passed the Senate unanimously late last year, 
but was not considered by the House before we adjourned sine die. 
Because the June deadline looms so near, I hope that we can move this 
bill quickly and without amendment through both Houses before the July 
1 reversion of Hong Kong to China's jurisdiction.
                                 ______
                                 
      By Mr. THOMAS (for himself and Mr. Robb):
  S. 343. A bill to authorize the extension of nondiscriminatory 
treatment (most-favored-nation treatment) to the products of Mongolia; 
to the Committee on Finance.


                        MONGOLIA MFN LEGISLATION

  Mr. THOMAS. Mr. President, I rise as chairman of the Subcommittee on 
East

[[Page S1471]]

Asian and Pacific Affairs to introduce S. 343, a bill to authorize the 
extension of nondiscriminatory treatment--formerly known as ``most-
favored nation status''--to the products of Mongolia. I am pleased to 
be joined by Senator Robb and Senator McCain as original cosponsors.
  Mongolia has undergone a series of remarkable and dramatic changes 
over the last few years. Sandwiched between the former Soviet Union and 
China, it was one of the first countries in the world to become 
Communist after the Russian Revolution. After 70 years of Communist 
rule, though, the Mongolian people have recently made great progress in 
establishing a democratic political system and creating a free-market 
economy. Just last year, the country held its third election under its 
new constitution, resulting in a parliamentary majority for the 
coalition of democratic opposition parties. Rather than attempt to 
maintain its hold on power, the former government peaceably--and 
commendably--transferred power to the new government.
  Mongolia has demonstrated a strong desire to build a friendly and 
cooperative relationship with the United States on trade and related 
matters since its turn towards democracy. We concluded a bilateral 
trade treaty with that country in 1991, and a bilateral investment 
treaty in 1994. Mongolia has received nondiscriminatory trading status 
since 1991, and has been found to be in full compliance with the 
freedom of emigration requirements of title IV of the Trade Act of 
1974. In addition, it has acceded to the agreement establishing the 
World Trade Organization.
  Mr. President, Mongolia has clearly demonstrated that it is fully 
deserving of joining the ranks of those countries to which we extend 
nondiscriminatory trade status. The extension of that status would not 
only serve to commend the Mongolians on their impressive progress, but 
would also enable the United States to avail itself of all its rights 
under the WTO with respect to Mongolia.
  I have another, more parochial, reason for being interested in MFN 
status for Mongolia. Mongolia and my home State of Wyoming are sister 
States; a strong relationship between the two has developed over the 
last 4 years. Many of Mongolia's provincial governors have visited the 
State, and the two governments have established partnerships in 
education, agriculture, and livestock management. Like Wyoming, 
Mongolia is a high plateau with mountains on the northwest border, 
where many of the residents make their living by raising livestock. I 
am pleased to see the development of this mutually beneficial 
relationship, and am sure that the extension of nondiscriminatory trade 
status will serve to strengthen it further.
  Mr. President, I introduced an identical bill in the last Congress at 
the very end of the legislative year, as did Congressman Bereuter in 
the House. We both realized that it was too late in the year to move 
the legislation forward before we adjourned sine die, but we hoped that 
by introducing the bill then that it would serve as a catalyst to 
serious discussion of the issue in this Congress. I was very 
appreciative that last year the distinguished chairman of the Finance 
Committee, Senator Roth, indicated his willingness to favorably 
consider the legislation early in this Congress, and look forward to 
working with him.
                                 ______
                                 
      By Mrs. BOXER:
  S. 344. A bill to require the relocation of a National Weather 
Service radar tower which is on Sulphur Mountain near Ojai, CA; to the 
Committee on Commerce, Science, and Transportation.


                  national weather service legislation

 Mrs. BOXER. Mr. President, I ask unanimous consent that the 
text of the bill be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 344

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. RELOCATION OF RADAR TOWER.

       (a) Requirement To Relocate Radar Tower.--Not later than 18 
     months after the date of the enactment of this Act, the 
     Secretary shall relocate the National Weather Service radar 
     tower which is located on Sulphur Mountain near Ojai, 
     California, to a site which complies with the criteria listed 
     in subsection (b).
       (b) Criteria for New Site.--The new site for the radar 
     tower referred to in subsection (a) shall be selected so that 
     the relocation--
       (1) will not result in degradation of service; and
       (2) will minimize the negative impact of the radar tower on 
     residential areas.
       (c) Report.--Not later than 6 months after the date of the 
     enactment of this Act, the Secretary shall transmit a report 
     to Congress that includes--
       (1) an identification of the new site selected for the 
     radar tower; and
       (2) evidence which was considered in reaching the 
     conclusion that relocation of the radar tower to the site 
     selected meets the criteria listed in subsection (b).

     SEC. 2. DEFINITIONS.

       For the purposes of this Act--
       (1) the term ``degradation of service'' means any decrease 
     in or failure to maintain the quality and type of weather 
     services provided by the National Weather Service to the 
     public; and
       (2) the term ``Secretary'' means the Secretary of 
     Commerce.
                                 ______
                                 
      By Mr. ROBB:
  S. 345. A bill to amend chapter 57 of title 5, United States Code, to 
provide for the payment to Federal employees of meal expenses required 
while serving on a security detail in the protection of a Federal 
officer, and for other purposes; to the Committee on Governmental 
Affairs.


                      FEDERAL EMPLOYEE LEGISLATION

 Mr. ROBB. Mr. President, today I introduce legislation to 
right an obvious wrong. As I was reading the Washington Post on January 
6, 1997, I ran across a brief mention that employees of the CIA who are 
assigned to protect the Director of Central Intelligence must pay their 
own way when they are forced to buy meals because of their assigned 
protection duties.
  Evidently these Federal employees are required to keep a line of 
sight on the Director 24 hours a day, which sometimes entails following 
him to restaurants. These restaurants in turn refuse to let the 
protection detail occupy a table without purchasing a meal. While this 
may sound trivial, I do not believe it is fair to require a Federal 
employee to buy an expensive meal as part of their job. I am sure 
you'll agree that if a person is going to spend that kind of money on a 
meal, they should be enjoying it with a good friend or loved one, not 
watching their boss across the room.
  For that reason, I am introducing this bill, which would authorize 
any Federal agency to pay the meal expenses for cases like this one for 
an employee who is serving on a 24-hour-a-day security detail which 
requires the employee to remain in the line of sight of the person 
being protected. I understand that certain agencies already have this 
authority, but it clearly should be extended to all Federal agencies. I 
hope that this noncontroversial measure can be examined by the 
appropriate committee and quickly passed. The existing situation is 
blatantly unfair and needs to be changed.
  Mr. President, I ask unanimous consent that the article be printed in 
the Record.
  There being no objection, the article was ordered to be printed in 
the Record, as follows:

                          Looks Unlike America

                             (By Al Kamen)

       Even some of the Clinton administration diversity policy 
     were embarrassed by President Clinton's strong-arming 
     Transportation Secretary Federico Pena into accepting a 
     nomination to be energy secretary--a job for which he is 
     notably lacking in credentials.
       But the ethno-gender contortions were deemed, in the best 
     inside-the-Beltway political wisdom, essential to pay off the 
     Hispanic vote with two Cabinet seats.
       Yet, after so much effort expended on Cabinet diversity, 
     the Clinton White House itself remains a comfortable, mostly 
     white boys club, with hardly an African American, Latino or 
     Asian American in any senior job.
       With the anticipated departure of public liaison office 
     director Alexis M. Herman, the only minority in the top 25 or 
     so senior staff members is first lady Hillary Rodham 
     Clinton's chief of staff, Margaret A. Williams--and she may 
     leave soon.
       New Chief of Staff Erskine B. Bowles has three openings--
     and may have more--at that assistant to the president level: 
     a political affairs director to replace Douglas Sosnik, who 
     moved up to be ``counselor''; a replacement for Herman; and 
     one for outgoing White House counsel Jack Quinn.
       Administration officials say to keep an eye on former 
     representative Alan Wheat (D-Mo.) and the Labor Department's 
     wage and hour division chief Maria Echaveste, both mentioned 
     for Cabinet jobs.
       But ``Look Like America''? Not the senior staff.

[[Page S1472]]

                             In Like Quinn?

       Speaking of Quinn, the search goes on for a replacement, 
     and the list doesn't appear too long. The problem, as one 
     senior administration official put it, is ``finding someone 
     who's smart enough to do it and yet dumb enough to take it.''
       The most prominently mentioned name for the job is former 
     U.S. attorney Charles F.C. Ruff, who had been under 
     consideration for the attorney generalship after Zoe E. Baird 
     went down in flames until it was discovered he had a nanny 
     problem himself. Ruff is public-service minded, so he might 
     be persuaded. And he's been a partner at Covington & Burling, 
     so he presumably would have enough savings to cover his legal 
     fees.


                            Career Counselor

       Job alert. There are lots of openings in the counsel's 
     office.
       Associate White House counsel Elena Kagan, a tenured 
     constitutional law professor on leave from the University of 
     Chicago, had two going-away parties, the movers ready to go 
     and a class waiting for her today. But the students will have 
     to wait. New domestic policy chief Bruce Reed persuaded her 
     to stick around and be his top deputy.
       Another associate counsel, David B. Fein, however, stuck 
     with his original plan and has gone to private practice in 
     Connecticut. Even before Quinn threw in the towel, he was 
     looking for staff. Shortly after the election, Quinn asked 
     U.S. Attorney Eric H. Holder Jr. to ``make referrals and 
     recommendations to him about individuals who might be 
     interested in moving to the White House Counsel's Office 
     in the new administration,'' according to a memo Holder 
     sent his assistants.
       ``So that I can be responsive to Quinn,'' Holder said, ``I 
     would like to gather the names of those interested in this 
     opportunity and will then personally forward them to Quinn. . 
     . . (And don't worry, I won't hold it against you for 
     expressing interest in this opportunity--I think it's a great 
     one!)''


                              dinner duty

       Browsing on the General Accounting Office World Wide Web 
     page (we obviously need to get out more), we came across the 
     Ebenezer Scrooge Memorial Memo of 1996. The Dec. 30 GAO 
     decision memo involves a CIA request to reimburse members of 
     the director's security detail for meals they were obliged to 
     buy on duty.
       ``According to the CIA,'' the memo says, the security folks 
     traveling with the director or deputy are to ``remain in the 
     line of sight of the official they are protecting. On 
     occasion [they] must accompany one of the officials'' to area 
     restaurants and sit at nearby tables so as to be unobtrusive 
     but in the line of sight. ``Some restaurants require that 
     members of the detail order meals while sitting at these 
     tables. The cost of these meals, often substantial, has been 
     borne by the individual members of the detail,'' the memo 
     said, adding that the agency thinks it, not the overworked 
     security people, should pick up the tab.
       Tough luck, the GAO said. The law says no government 
     employee can get a free meal while at ``a normal duty 
     station,'' except for ``extreme emergency situations,'' and 
     this isn't one of them. Congress can and has overridden the 
     restriction for some agencies, but not for the CIA. So until 
     Congress acts, the security detail pays.


                             starring roles

       John D. Bates, deputy independent counsel in charge of the 
     Washington operation for Kenneth W. Starr, is resuming his 
     responsibilities at the end of this month as head of the 
     civil division in the U.S. Attorney's Office here. Bates had 
     been on a six-month leave that somehow stretched two years. 
     But he'll continue to oversee some matters at Starr's shop 
     for some time. Assistant U.S. Attorney Eric A. Dubelier, who 
     had been working on White House travel office matters for 
     Starr, also has returned to run the terrorism section of the 
     criminal division, while continuing to do some work in the 
     counsel operation. Should we read something into this? 
     Probably not.


                         life after legislature

       Retiring Sen. Sam Nunn (D-Ga.), who chaired the Armed 
     Services Committee back when Democrats were in the majority, 
     has signed on as a partner in King & Spaulding's Atlanta 
     office, with a second office here.
       Outgoing Rep. Robert S. Walker (R-Pa.), who chaired the 
     Science Committee and the House Republican Leadership, is off 
     to be president of the Wexler Group.
                                 ______
                                 
      By Mr. WELLSTONE:
  S. 346. A bill to assure fairness and assistance to patients and 
health care providers, and for other purposes; to the Committee on 
Labor and Human Resources.


                   THE PATIENT PROTECTION ACT OF 1997

 Mr. WELLSTONE. Mr. President, I introduce the Patient 
Protection Act of 1997. This bill addresses the issue of fairness in 
health care today.
  Mr. President, the last few years have seen an enormous growth in 
managed care health plans. Now, more than 50 percent of Americans are 
enrolled in some kind of managed care arrangement. We have learned a 
lot in the past several years about what works and what doesn't in 
managed care, in all kinds of health insurance for that matter.
  And, let me be clear that I recognize that there are things that are 
working well in managed care and other types of plans. We have seen a 
decrease in the rate of increase in healthcare costs. Health plans are 
emphasizing prevention and early intervention. Health plans are largely 
moving from managing costs to managing care to managing health.
  All of this is good, but enough time has gone by that we have found 
the problems, the glitches, the occasions and circumstances where 
patient and providers are not equal stakeholders in the systems and 
where they are treated unfairly, where their voices are either silent 
or disregarded. I am deeply concerned about the lack of availability of 
protections for patients and providers participating in all forms of 
health plans. This includes not only managed care plans in their 
various forms, but also point-of-service and traditional--fee-for-
service--plans as well. The inclusion of self-insured plans, MEWA's 
multiple employer welfare agreements--and association plans is an 
important component of this act because it extends provisions to some 
of those consumers who most need the protections.
  Many States are currently developing and moving similar bills through 
their legislatures and assemblies. There is a clear cry for these 
corrections and protections. However, even if all 50 States were to 
pass patient protection acts, not all Americans would benefit from  
these protections. I believe that now more than ever, Federal standards 
are needed to ensure that consumers are protected in our rapidly 
changing health care delivery environment. Almost 50 percent of 
Americans, those who belong to health plans regulated by the Federal 
Government, are excluded from State based protections. According to a 
report released by the GAO in July 1995, 44 million Americans are 
covered under exempt plans. There are an additional 70 million who are 
covered by other employer plans that may also be outside of the realm 
of State authority. In addition, self-funded plans are becoming more 
common, especially in smaller businesses. The standards that I am 
proposing should assure fairness for consumers and providers, while 
still encouraging health plans to pursue innovative approaches to 
providing high quality, cost-effective care. I am sure, Mr. President, 
that each of us is committed to fairness and understands the need for 
the Federal Government to work cooperatively with the States on this 
issue.

  My Patient Protection Act of 1997 will do several things that will 
ease the confusion so often present for consumers and providers in the 
health care system. It will assist them with their rights as 
participants in health plans.
  The act will award a grant to each State to establish an office of 
consumer education counseling, and assistance with health care. This 
will help consumers choose among the many plans available to them, 
understand their rights for appeals if care that their provider advises 
is denied, and receive support if they undertake a grievance procedure. 
These offices will be modeled after the successful ones in the Medicare 
Program, staffed largely by volunteers, that have helped seniors find 
their way through what might be for many an overwhelming situation.
  The act will require that health plans disclose certain information 
so that consumers and providers are better informed. Information that 
must be disclosed ranges from the financial health of the plan to its 
internal review process and criteria used in making decisions about 
treatment. No longer will there be a black hole in health plans into 
which very personal information about a patient goes, something unknown 
happens and out comes a decision to treat or not treat the problem. 
That simply is not the way to provide health care in a democracy.
  The act will require that plans ensure timely access to services and 
specialized treatment expertise, when clinically indicated.
  The act will require the development of health plan standards, 
including utilization review activities and handling of grievances of 
consumers or providers. Providers and consumers will be involved in the 
development of these processes.
  The act will protect providers by requiring mechanisms for due 
process

[[Page S1473]]

and disallowing dismissal of providers from the panel of a health plan 
without cause. It adds antigag clause and whistle-blower protection in 
order to ensure that consumers receive information that they need about 
health care options and quality of health care.
  In a country where many are either uninsured or underinsured, it is 
especially important that attempts to control costs be accompanied by 
clear legal rights for consumers and providers. With a competitive 
insurance market lacking adequate consumer protections and a health 
care system that says it's OK to leave some people out, what's to 
prevent plans from discriminating against patients who are likely to 
need expensive clinical services?
  Mr. President, these are not anti-managed care provisions. As a 
matter of fact, they are not anti anything. They are positive steps 
that will restore a better balance between health plans, consumers, and 
providers. Responsible health plans already comply with the standards 
that the Patient Protection Act would establish. But the Patient 
Protection Act would ensure that all patients and providers are 
guaranteed at least a baseline of protection.
  We are currently seeing attempts to regulate health care on a 
disease-by-disease basis. This is not the best way to protect consumers 
and providers. We need to focus on maintaining the unique relationship 
between health care providers and their patients, so that optimal care 
is available. Congress should not be in the business of deciding how 
long a patient needs to stay in the hospital for treatment of a 
specific condition, or whether a specific technology should be offered 
to a specific patient. We should instead make certain that health care 
providers can take into account the uniqueness of each of their 
patients in developing a rational and appropriate plan of care that can 
be followed. We can do this by ensuring that consumers and providers 
are included in the utilization review and decisionmaking process. The 
framework provided by the Patient Protection Act of 1997 will allow 
this to occur.
  These issues will become increasingly important as managed care 
arrangements proliferate, competition increases, more and more 
Americans and children lose their health insurance coverage, and costs 
continue to escalate. Until we are willing to make the hard choices and 
deal with the underlying problems in our current system, the very least 
we should do is enact some sensible protections that safeguard 
patients' and providers' rights.
  Mr. President, many people are fond of saying that health care reform 
is happening now--employers are managing their costs by enrolling 
increasing numbers of employees in managed care plans and new provider 
networks are emerging daily. But with so much attention being paid to 
the cost and business of health care, the providers and patients are 
losing substantial control over decisions affecting patients' health. 
It is therefore all the more important that we provide patient and 
provider protections. The Patient Protection Act of 1997 will go a long 
way toward doing that.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 346

       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 ``Patient 
     Protection Act of 1997''.
       (b) Table of Contents.--The table of contents for this Act 
     are as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Definitions.

  TITLE I--OFFICE FOR CONSUMER INFORMATION, COUNSELING AND ASSISTANCE 
                            WITH HEALTH CARE

Sec. 101. Establishment.

                    TITLE II--UTILIZATION MANAGEMENT

Sec. 201. Definitions.
Sec. 202. Requirement for utilization review program.
Sec. 203. Standards for utilization review.

                    TITLE III--HEALTH PLAN STANDARDS

Sec. 301. Health plan standards.
Sec. 302. Minimum solvency requirements.
Sec. 303. Information on terms of plan.
Sec. 304. Access.
Sec. 305. Credentialing for health providers.
Sec. 306. Grievance procedures.
Sec. 307. Confidentiality standards.
Sec. 308. Discrimination.
Sec. 309. Prohibition on selective marketing.

                   TITLE IV--MISCELLANEOUS PROVISIONS

Sec. 401. Enforcement.
Sec. 402. Effective date.
Sec. 403. Preemption.

     SEC. 2. DEFINITIONS.

       Unless specifically provided otherwise, as used in this 
     Act:
       (1) Carrier.--The term ``carrier'' means a licensed 
     insurance company, a hospital or medical service corporation 
     (including an existing Blue Cross or Blue Shield 
     organization, within the meaning of section 833(c)(2) of 
     Internal Revenue Code of 1986 as in effect before the date of 
     the enactment of this Act), a health maintenance 
     organization, or other entity licensed or certified by the 
     State to provide health insurance or health benefits.
       (2) Covered individual.--The term ``covered individual'' 
     means a member, enrollee, subscriber, covered life, patient 
     or other individual eligible to receive benefits under a 
     health plan.
       (3) Emergency services.--The term ``emergency services'' 
     means those health care services that are provided to a 
     patient after the sudden onset of a health condition that 
     manifests itself by symptoms of sufficient severity, 
     including severe pain, and the absence of such immediate 
     health care attention could reasonably be expected, to result 
     in--
       (A) placing the patient's health in serious jeopardy;
       (B) serious impairment to bodily function; or
       (C) serious dysfunction of any bodily organ or part.
       (4) Health plan.--The term ``health plan'' includes any 
     organization that seeks to arrange for, or provide for the 
     financing and coordinated delivery of, health care services 
     directly or through a contracted health provider panel, and 
     shall include health maintenance organizations, preferred 
     provider organizations, single service health maintenance 
     organizations, single service preferred provider 
     organizations, other entities such as provider-hospital or 
     hospital-provider organizations, employee welfare benefit 
     plans (as defined in section 3(1) of the Employee Retirement 
     Income Security Act of 1974 (29 U.S.C. 1002(1)), and multiple 
     employer welfare plans or other association plans, as well as 
     carriers.
       (5) Health provider.--The term ``health provider'' means an 
     individual who is licensed or certified under State law to 
     provide health care services and who is operating within the 
     scope of such licensure or certification.
       (6) Managed care plan.--
       (A) In general.--The term ``managed care plan'' means a 
     plan operated by a managed care entity (as defined in 
     subparagraph (B)), that provides for the financing and 
     delivery of health care services to persons enrolled in such 
     plan through--
       (i) arrangements with selected providers to furnish health 
     care services;
       (ii) explicit standards for the selection of participating 
     providers;
       (iii) organizational arrangements for ongoing quality 
     assurance, utilization review programs, and dispute 
     resolution; and
       (iv) financial incentives for persons enrolled in the plan 
     to use the participating providers and procedures provided 
     for by the plan.
       (B) Managed care entity.--The term ``managed care entity'' 
     includes a licensed insurance company, hospital or medical 
     service plan (including provider and provider-hospital 
     networks), health maintenance organization, an employer or 
     employee organization, or a managed care contractor (as 
     defined in subparagraph (C)), that operates a managed care 
     plan.
       (C) Managed care contractor.--The term ``managed care 
     contractor'' means a person that--
       (i) establishes, operates, or maintains a network of 
     participating providers;
       (ii) conducts or arranges for utilization review 
     activities; and
       (iii) contracts with an insurance company, a hospital or 
     health service plan, an employer, an employee organization, 
     or any other entity providing coverage for health care 
     services to operate a managed care plan.
       (7) Provider network.--The term ``provider network'' means, 
     with respect to a health plan that restricts access, those 
     providers who have entered into a contract or agreement with 
     the plan under which such providers are obligated to provide 
     items and services under the plan to eligible individuals 
     enrolled in the plan, or have an agreement to provide 
     services on a fee-for-service basis.
       (8) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services unless specifically provided 
     otherwise .
       (9) Specialized treatment expertise.--The term 
     ``specialized treatment expertise'' means expertise in 
     diagnosing and treating unusual diseases and conditions, 
     diagnosing and treating diseases and conditions that are 
     usually difficult to diagnose or treat, and providing other 
     specialized health care.
       (10) Sponsor.--The term ``sponsor'' means a carrier or 
     employer that provides a health plan.
       (11) Utilization review.--The term ``utilization review'' 
     means a set of formal techniques designed to monitor and 
     evaluate the

[[Page S1474]]

     clinical necessity, appropriateness and efficiency of health 
     care services, procedures, providers and facilities. 
     Techniques may include ambulatory review, prospective review, 
     second opinion, certification, concurrent review, case 
     management, discharge planning and retrospective review.
  TITLE I--OFFICE FOR CONSUMER INFORMATION, COUNSELING AND ASSISTANCE 
                            WITH HEALTH CARE

     SEC. 101. ESTABLISHMENT.

       (a) In General.--The Secretary shall award a grant to each 
     State and each State shall use amounts received under the 
     grant to establish an Office for Consumer Information, 
     Counseling and Assistance with Health Care (referred to in 
     this section as the ``Office''). Each such Office shall 
     perform public outreach and provide education and assistance 
     concerning consumer rights with respect to health insurance 
     and benefits as provided for in subsection (d).
       (b) Use of Grant.--
       (1) In general.--A State shall use a grant under this 
     section--
       (A) to administer the Office and carry out the duties 
     described in subsection (d);
       (B) to solicit and award contracts to private, nonprofit 
     organizations applying to the State to administer the Office 
     and carry out the duties described in subsection (d); or
       (C) in the case of a State operating a consumer information 
     counseling and assistance program on the date of enactment of 
     this Act, to expand and improve such program.
       (2) Contracts.--With respect to the contract described in 
     paragraph (1)(B), the contract period shall be not less than 
     2 years and not more than 4 years.
       (c) Staff.--A State shall ensure that the Office has 
     sufficient staff (including volunteers) and local offices 
     throughout the State to carry out its duties under this 
     section and a demonstrated ability to represent and work with 
     a broad spectrum of consumers, including vulnerable and 
     underserved populations.
       (d) Duties.--An Office established under this section 
     shall--
       (1) establish a State-wide toll-free hotline to enable 
     consumers to contact the Office;
       (2) have the ability to provide culturally appropriate 
     assistance that as far as practicable takes into 
     consideration under this subsection language needs;
       (3) develop outreach programs to provide health insurance 
     and health benefits information, counseling, and assistance;
       (4) provide outreach and education relating to consumer 
     rights and responsibilities under this Act, including the 
     rights and services available through the Office;
       (5) provide individuals with assistance in enrolling in 
     health plans (including providing plan comparisons), or in 
     obtaining services or reimbursements from health plans;
       (6) provide individuals with assistance in filing 
     applications for appropriate State health plan premium 
     assistance programs;
       (7) provide individuals with information and advocacy 
     concerning existing grievance procedures and institute 
     systems of referral to appropriate Federal or State 
     departments or agencies for assistance with problems related 
     to insurance coverage (including legal problems);
       (8) ensure that regular and timely access is provided to 
     the services available through the Office;
       (9) implement training programs for staff members 
     (including volunteer staff members) and collect and 
     disseminate timely and accurate health care information to 
     staff members;
       (10) not less than once each year, conduct public hearings 
     to identify and address community health care needs;
       (11) coordinate its activities with the staff of the 
     appropriate departments and agencies of the State government 
     and other appropriate entities within the State; and
       (12) carry out any other activities determined appropriate 
     by the Secretary.
       (e) State Duties.--
       (1) Access to information.--The State shall ensure that, 
     for purposes of carrying out the duties of the Office, the 
     Office has appropriate access to relevant information, 
     subject to the application of procedures to ensure 
     confidentiality of enrollee and proprietary health plan 
     information.
       (2) Reporting and evaluation requirements.--
       (A) Report.--The Office shall annually prepare and submit 
     to the State a report on the nature and patterns of consumer 
     complaints received by the Office during the year for which 
     the report is prepared. Such report shall contain any policy, 
     regulatory, and legislative recommendations for improvements 
     in the activities of the Office together with a record of the 
     activities of the Office.
       (B) Evaluation.--The State shall annually evaluate the 
     quality and effectiveness of the Office in carrying out the 
     activities described in subsection (d).
       (3) Conflicts of interest.--The State shall ensure that no 
     individual involved in selecting the entity with which to 
     enter into a contract under subsection (b)(1)(B), or involved 
     in the operation of the Office, or any delegate of the 
     Office, is subject to a conflict of interest.
       (f) Authorization of Appropriations.--There are authorized 
     to be appropriated such sums as may be necessary to carry out 
     this section.
                    TITLE II--UTILIZATION MANAGEMENT

     SEC. 201. DEFINITIONS.

       As used in this title:
       (1) Adverse determination.--The term ``adverse 
     determination'' means a determination that an admission to or 
     continued stay at a hospital or that another health care 
     service that is required has been reviewed and, based upon 
     the information provided, does not meet the requirements for 
     clinical necessity, appropriateness, level of care, or 
     effectiveness.
       (2) Ambulatory review.--The term ``ambulatory review'' 
     means utilization review of health care services performed or 
     provided in an outpatient setting.
       (3) Appeals procedure.--The term ``appeals procedure'' 
     means a formal process under which a covered individual (or 
     an individual acting on behalf of a covered individual), 
     attending provider or facility may appeal an adverse 
     utilization review decision rendered by the health plan or 
     its designee utilization review organization.
       (4) Care coordinator.--The term ``care coordinator'' means 
     a health provider who performs case management functions in 
     consultation with the interdisciplinary health care team, the 
     patient, family, and community.
       (5) Case management.--The term ``case management'' means a 
     coordinated set of activities conducted for the individual 
     patient management of serious, complicated, protracted or 
     chronic health conditions that provides cost-effective and 
     benefit-maximizing treatments for extremely resource-
     intensive conditions.
       (6) Clinical review criteria.--The term ``clinical review 
     criteria'' means the recorded (written or otherwise) 
     screening procedures, decision abstracts, clinical protocols 
     and practice guidelines used by the health plan to determine 
     necessity and appropriateness of health care services.
       (7) Comparable.--The term ``comparable'' means a health 
     provider who is licensed or certified in a manner that 
     permits the provider to authorize the equipment, services, or 
     procedures that are the subject of a review.
       (8) Concurrent review.--The term ``concurrent review'' 
     means utilization review conducted during a patient's 
     hospital stay or course of treatment.
       (9) Discharge planning.--The term ``discharge planning'' 
     means the formal process for determining, coordinating and 
     managing the care a patient receives following the discharge 
     of the patient from a facility.
       (10) Facility.--The term ``facility'' means an institution 
     or health care setting providing the prescribed health care 
     services under review. Such term includes hospitals and other 
     licensed inpatient facilities, ambulatory surgical or 
     treatment centers, skilled nursing facilities, residential 
     treatment centers, diagnostic, laboratory and imaging centers 
     and rehabilitation and other therapeutic health care 
     settings.
       (11) Prospective review.--The term ``prospective review'' 
     means utilization review conducted prior to an admission or a 
     course of treatment.
       (12) Retrospective review.--The term ``retrospective 
     review'' means utilization review conducted after health care 
     services have been provided to a patient. Such term does not 
     include the retrospective review of a claim that is limited 
     to an evaluation of reimbursement levels, veracity of 
     documentation, accuracy of coding and adjudication for 
     payment.
       (13) Second opinion.--The term ``second opinion'' means an 
     opportunity or requirement to obtain a clinical evaluation by 
     a provider other than the provider originally making a 
     recommendation for a proposed health service to assess the 
     clinical necessity and appropriateness of the initial 
     proposed health service.
       (14) Utilization review organization.--The term 
     ``utilization review organization'' means an entity that 
     conducts utilization review.

     SEC. 202. REQUIREMENT FOR UTILIZATION REVIEW PROGRAM.

       A health plan shall have in place a utilization review 
     program that meets the requirements of this title and that is 
     certified by the State.

     SEC. 203. STANDARDS FOR UTILIZATION REVIEW.

       (a) Establishment.--The Secretary of Health and Human 
     Services, in consultation with the Secretary of Labor 
     (referred to in this title as the ``Secretaries''), shall 
     establish standards for the establishment, operation, and 
     certification and periodic recertification of health plan 
     utilization review programs.
       (b) Alternative Standards.--
       (1) In general.--A State may certify a health plan as 
     meeting the standards established under subsection (a) if the 
     State determines that the health plan has met the utilization 
     standards required for accreditation as applied by a 
     nationally recognized, independent, nonprofit accreditation 
     entity.
       (2) Review by state.--A State that makes a determination 
     under paragraph (1) shall periodically review the standards 
     used by the private accreditation entity to ensure that such 
     standards meet or exceed the standards established by the 
     Secretaries under this title.
       (c) Utilization Review Program Requirements.--The standards 
     developed by the Secretaries under subsection (a) shall 
     require that utilization review programs comply with the 
     following:
       (1) Documentation.--A health plan shall provide a written 
     description of the utilization review program of the plan, 
     including a description of--

[[Page S1475]]

       (A) any activities assigned from the health plan to other 
     entities;
       (B) the policies and procedures used under the program to 
     evaluate clinical necessity; and
       (C) the clinical review criteria, information sources, and 
     the process used to review and approve the provision of 
     health care services under the program.
       (2) Prohibition.--With respect to the administration of the 
     utilization review program, a health plan may not employ 
     utilization reviewers or contract with a utilization 
     management organization if the conditions of employment or 
     the contract terms include financial incentives to reduce or 
     limit the provision of clinically necessary or appropriate 
     services to covered individuals.
       (3) Review and modification.--A health plan shall develop 
     procedures for periodically reviewing and modifying the 
     utilization review of the plan. Such procedures shall provide 
     for the participation of providers and consumers in the 
     health plan in the development and review of utilization 
     review policies and procedures.
       (4) Decision protocols.--
       (A) In general.--A utilization review program shall develop 
     and apply recorded (written or otherwise) utilization review 
     decision protocols. Such protocols shall be based on sound 
     health care evidence.
       (B) Protocol criteria.--The clinical review criteria used 
     under the utilization review decision protocols to assess the 
     appropriateness of health care services shall be clearly 
     documented and available to participating health providers 
     upon request. Such protocols shall include a mechanism for 
     assessing the consistency of the application of the criteria 
     used under the protocols across reviewers, and a mechanism 
     for periodically updating such criteria.
       (5) Review and decisions.--
       (A) Review.--The procedures applied under a utilization 
     review program with respect to the preauthorization and 
     concurrent review of the necessity and appropriateness of 
     health care devices, services or procedures, shall require 
     that qualified, comparable health care providers supervise 
     review decisions. With respect to a decision to deny the 
     provision of health care devices, services or procedures, a 
     comparable provider shall conduct a subsequent review to 
     determine the clinical appropriateness of such a denial. 
     Comparable health providers from the appropriate specialty 
     area shall be utilized in the review process.
       (B) Decisions.--All utilization review decisions shall be 
     made in a timely manner, as determined appropriate when 
     considering the urgency of the situation.
       (C) Adverse determinations.--With respect to utilization 
     review, an adverse determination or noncertification of an 
     admission, continued stay, or service shall be clearly 
     documented, including the specific clinical or other reason 
     for the adverse determination or noncertification, and be 
     available to the covered individual and the affected provider 
     or facility. A health plan may not deny or limit coverage 
     with respect to a service that the enrollee has already 
     received solely on the basis of lack of prior authorization 
     or second opinion, to the extent that the service would have 
     otherwise been covered by the plan had such prior 
     authorization or a second opinion been obtained.
       (D) Notification of denial.--A health plan shall provide a 
     covered individual with timely notice of an adverse 
     determination or noncertification of an admission, continued 
     stay, or service. Such a notification shall include 
     information concerning the utilization review program appeals 
     procedure as well as the telephone number for the Office.
       (6) Requests for authorization.--A health plan utilization 
     review program shall ensure that requests by covered 
     individuals or providers for prior authorization of a 
     nonemergency service shall be answered in a timely manner 
     after such request is received. If utilization review 
     personnel are not available in a timely fashion, any health 
     care services provided shall be considered approved.
       (7) New technologies.--A utilization review program shall 
     implement policies and procedures to evaluate the appropriate 
     use of new health care technologies or new applications of 
     established technologies, including health care procedures, 
     drugs, and devices. The program shall ensure that appropriate 
     providers participate in the development of technology 
     evaluation criteria.
       (8) Special rule.--Where prior authorization for a service 
     or other covered item is obtained under a program under this 
     section, the service shall be considered to be covered unless 
     there was intentional fraud or intentionally incorrect 
     information provided at the time such prior authorization was 
     obtained. If a provider intentionally supplied the incorrect 
     information that led to the authorization of clinically 
     unnecessary care, the provider shall be prohibited from 
     collecting payment directly from the enrollee, and shall 
     reimburse the plan and subscriber for any payments or 
     copayments the provider may have received.
       (d) Health Plan Requirements.--
       (1) Disclosure of information.--
       (A) Prospective covered individuals.--A health plan shall, 
     with respect to any materials distributed to prospective 
     covered individuals, include a summary of the utilization 
     review procedures of the plan.
       (B) Covered individuals.--A health plan shall, with respect 
     to any materials distributed to newly covered individuals, 
     include a clear and comprehensive description of utilization 
     review procedures of the plan and a statement of patient 
     rights and responsibilities with respect to such procedures.
       (C) State officials.--
       (i) In general.--A health plan shall disclose to the State 
     insurance commissioner, or other designated State official, 
     the health plan utilization review program policies, 
     procedures, and reports required by the State for 
     certification.
       (ii) Streamlining of procedures.--To the extent 
     practicable, a State shall implement procedures to streamline 
     the process by which a health plan documents compliance with 
     the requirements of this Act, including procedures to 
     condense the number of documents filed with the State 
     concerning such compliance.
       (2) Toll-free number.--A health plan shall have a 
     membership card which shall have printed on the card the 
     toll-free telephone number that a covered individual should 
     call to receive precertification utilization review 
     decisions.
       (3) Evaluation.--A health plan shall establish mechanisms 
     to evaluate the effects of the utilization review program of 
     the plan through the use of member satisfaction data or 
     through other appropriate means.
       (e) Emergency Care.--
       (1) Emergency medical condition.--For purposes of this 
     section the term ``emergency medical condition'' means a 
     medical condition manifesting itself by acute symptoms of 
     sufficient severity (including severe pain) such that a 
     prudent layperson (including the parent of a minor child or 
     the guardian of a disabled individual), who possesses an 
     average knowledge of health and medicine, could reasonably 
     expect the absence of immediate medical attention to result 
     in--
       (A) placing the health of the individual (or, with respect 
     to a pregnant woman, the health of the woman or her unborn 
     child) in serious jeopardy,
       (B) serious impairment to bodily functions, or
       (C) serious dysfunction of any bodily organ or part.
       (2) Preauthorization.--With respect to emergency services 
     furnished in a hospital emergency department, a health plan 
     shall not require prior authorization for the provision of 
     such services if the enrollee arrived at the emergency 
     department with symptoms that reasonably suggested an 
     emergency medical condition based on the judgment of a 
     prudent layperson, regardless of whether the hospital was 
     affiliated with the health plan. All procedures performed 
     during the evaluation and treatment of an emergency medical 
     condition shall be covered under the health plan.
                    TITLE III--HEALTH PLAN STANDARDS

     SEC. 301. HEALTH PLAN STANDARDS.

       (a) Establishment.--The Secretary of Health and Human 
     Services, in conjunction with the Secretary of Labor 
     (referred to in this title as the ``Secretaries''), shall 
     establish standards for the certification and periodic 
     recertification of health plans, including standards which 
     require plans to meet the requirements of this title.
       (b) State Certification.--
       (1) In general.--A State shall provide for the 
     certification of health plans if the certifying authority 
     designated by the State determines that the plan meets the 
     applicable requirements of this Act.
       (2) Requirement.--Effective on January 1, 1999, a health 
     plan sponsor may only offer a health plan in a State if such 
     plan is certified by the State under paragraph (1).
       (c) Construction.--Whenever in this title a requirement or 
     standard is imposed on a health plan, the requirement or 
     standard is deemed to have been imposed on the sponsor of the 
     plan in relation to that plan.

     SEC. 302. MINIMUM SOLVENCY REQUIREMENTS.

       (a) In General.--Except as provided in subsection (b), each 
     State shall apply minimum solvency requirements to all health 
     plans offered or operating within the State to ensure the 
     fiscal integrity of such plans. A health plan shall meet the 
     financial reserve requirements that are established by the 
     State to assure proper payment for health care services 
     provided under the plan. Such requirements may include plan 
     participation in a mechanism to provide for indemnification 
     of plan failures even if a plan has met the reserve 
     requirements.
       (b) Federal Standards.--The Secretaries shall establish 
     minimum solvency standards that shall apply to all self-
     insured health plans. Such standards shall at least meet the 
     solvency requirements established by the National Association 
     of Insurance Commissioners.

     SEC. 303. INFORMATION ON TERMS OF PLAN.

       (a) In General.--A health plan shall provide prospective 
     covered individuals with written information concerning the 
     terms and conditions of the health plan to enable such 
     individuals to make informed decisions with respect to a 
     certain system of health care delivery. Such information 
     shall be standardized so that prospective covered individuals 
     may compare the attributes of all such plans offered within 
     the coverage area.
       (b) Understandability.--Information provided under this 
     section, whether written or oral shall be easily 
     understandable, truthful, linguistically appropriate and 
     objective with respect to the terms used. Descriptions 
     provided in such information shall be consistent with 
     standards developed for supplemental insurance coverage under 
     title XVIII of the Social Security Act (42 U.S.C. 1395 et 
     seq.).

[[Page S1476]]

       (c) Required Information.--Information required under this 
     section shall include information concerning--
       (1) coverage provisions, benefits, and any exclusions by 
     category of service or product;
       (2) plan loss ratios with an explanation that such ratios 
     reflect the percentage of the premiums expended for health 
     services;
       (3) prior authorization or other review requirements 
     including preauthorization review, concurrent review, post-
     service review, post-payment review and procedures that may 
     lead the patient to be denied coverage for, or not be 
     provided, a particular service or product;
       (4) an explanation of how plan design impacts enrollees, 
     including information on the financial responsibility of 
     covered individuals for payment for coinsurance or other out-
     of-plan services;
       (5) covered individual satisfaction statistics, including 
     disenrollment statistics and satisfaction statistics from 
     those who disenroll;
       (6) advance directives and organ donation;
       (7) the characteristics and availability of health care 
     providers and institutions participating in the plan, 
     including descriptions of the financial arrangements or 
     contractual provisions with hospitals, utilization review 
     organizations, physicians, or any other provider of health 
     care services that would affect the services offered, 
     referral or treatment options, or provider's fiduciary 
     responsibility to patients, including financial incentives 
     regarding the provision of services; and
       (8) quality indicators for the plan and for participating 
     health providers under the plan, including population-based 
     statistics such as immunization rates and performance 
     measures such as survival after surgery, adjusted for case 
     mix.

     SEC. 304. ACCESS.

       (a) In General.--A health plan shall demonstrate that the 
     plan has a sufficient number, distribution, and variety of 
     qualified health care providers to ensure that all covered 
     health care services will be available and accessible in a 
     timely manner to adults, infants, children, and individuals 
     with disabilities enrolled in the plan. Plans shall make 
     reasonable efforts to address issues of cultural competence 
     and appropriateness with respect to providers.
       (b) Availability of Services.--A health plan shall ensure 
     that services covered under the plan are available in a 
     timely manner that ensures a continuity of care, are 
     accessible within a reasonable proximity to the residences of 
     the enrollees, are available within reasonable hours of 
     operation, and include emergency and urgent care services 
     when clinically necessary and available which shall be 
     accessible within the service area 24-hours a day, seven days 
     a week.
       (c) Specialized Treatment.--A health plan shall demonstrate 
     that plan enrollees have meaningful access, when clinically 
     indicated in the judgment of the treating health provider, to 
     specialized treatment expertise.
       (d) Chronic Conditions.--
       (1) In general.--Any process established by a health plan 
     to coordinate care and control costs may not impose an undue 
     burden on enrollees with chronic health conditions. The plan 
     shall ensure a continuity of care and shall, when clinically 
     indicated in the judgment of the treating health provider, 
     ensure ongoing direct access to relevant specialists for 
     continued care.
       (2) Care coordinator.--In the case of an enrollee who has a 
     severe, complex, or chronic condition, the health plan shall 
     determine, based on the judgment of the treating health 
     provider, whether it is clinically necessary or appropriate 
     to use a care coordinator from an interdisciplinary team.
       (e) Requirement.--
       (1) In general.--The requirements of this section may not 
     be waived and shall be met in all areas where the health plan 
     has enrollees, including rural areas. With respect to 
     children, such services shall include pediatric and pediatric 
     specialty services.
       (2) Out-of-network services.--If a health plan fails to 
     meet the requirements of this section, the plan shall arrange 
     for the provision of out-of-network services to enrollees in 
     a manner that provides enrollees with access to services in 
     accordance with the principles and parameters set forth in 
     this section.

     SEC. 305. CREDENTIALING FOR HEALTH PROVIDERS.

       (a) In General.--A health plan shall credential health 
     providers furnishing health care services under the plan.
       (b) Credentialing Process.--
       (1) In general.--A health plan shall establish a 
     credentialing process. Such process shall ensure that a 
     health provider is credentialed prior to that provider being 
     listed as a health provider in the health plan's marketing 
     materials, in accordance with recorded (written or otherwise) 
     policies and procedures.
       (2) Responsibility chief health care officer.--The chief 
     health care officer of the health plan, or another designated 
     health provider, shall have responsibility for the 
     credentialing of health providers under the plan.
       (3) Uniform applications.--A State shall develop a basic 
     uniform application that shall be used by all health plans in 
     the State for credentialing purposes.
       (4) Standards.--
       (A) In general.--Credentialing decisions under a health 
     plan shall be based on objective standards with input from 
     health providers credentialed under the plan. Information 
     concerning all application and credentialing policies and 
     procedures shall be made available for review by the health 
     providers involved upon written request.
       (B) Right to review information.--A health provider who 
     undergoes the credentialing process shall have the right to 
     review the basis information, including the sources of that 
     information, that was used to meet the designated 
     credentialing criteria.

     SEC. 306. GRIEVANCE PROCEDURES.

       (a) In General.--A health plan shall adopt a timely and 
     organized system for resolving complaints and formal 
     grievances filed by covered individuals. Such system shall 
     include--
       (1) recorded (written or otherwise) procedures for 
     registering and responding to complaints and grievances in a 
     timely manner;
       (2) documentation concerning the substance of complaints, 
     grievances, and actions taken concerning such complaints and 
     grievances, which shall be in writing, and be available upon 
     request to the Office for Consumer Information, Counseling 
     and Assistance with Health Care;
       (3) procedures to ensure a resolution of a complaint or 
     grievance;
       (4) the compilation and analysis of complaint and grievance 
     data;
       (5) procedures to expedite the complaint process if the 
     complaint involves a dispute about the coverage of an 
     immediately and urgently needed service; and
       (6) procedures to ensure that if an enrollee orally 
     notifies a health plan about a complaint, the plan (if 
     requested) must send the enrollee a complaint form that 
     includes the telephone numbers and addresses of member 
     services, a description of the plan's grievance procedure, 
     and the telephone number of the Officer for Consumer 
     Information, Counseling and Assistance with Health Care where 
     enrollees may register complaints.
       (b) Appeal Process.--A health plan shall adopt an appeals 
     process to enable covered individuals and providers to appeal 
     decisions that are adverse to the covered individuals. Such a 
     process shall include--
       (1) the right to a review by a grievance panel;
       (2) the right to a second review with a different panel, 
     independent from the health plan; and
       (3) an expedited process for review in emergency cases.

     The Secretaries shall develop guidelines for the structure 
     and requirements applicable to the independent review panel.
       (c) Notification.--With respect to the complaint, 
     grievance, and appeals processes required under this section, 
     a health plan shall, upon the request of a covered 
     individual, provide the individual a written decision 
     concerning a complaint, grievance, or appeal in a timely 
     fashion.
       (d) Non-Impediment to Benefits.--The complaint, grievance, 
     and appeals processes established in accordance with this 
     section may not be used in any fashion to discourage, 
     prevent, or deny a covered individual from receiving 
     clinically necessary care in a timely manner.
       (e) Due Process With Respect to Credentialing.--
       (1) Receipt of information.--A health provider who is 
     subject to credentialing under section 305 shall, upon 
     written request, receive from the health plan any information 
     obtained by the plan during the credentialing process that, 
     as determined by the credentialing committee, does not meet 
     the credentialing standards of the plan, or that varies 
     substantially from the information provided to the health 
     plan by the health provider.
       (2) Submission of corrections.--A health plan shall have a 
     formal, recorded (written or otherwise) process by which a 
     health provider may submit supplemental information to the 
     credentialing committee if the health provider determines 
     that erroneous or misleading information has been previously 
     submitted. The health provider may request that such 
     information be reconsidered in the evaluation for 
     credentialing purposes.
       (3) No entitlement.--
       (A) In general.--A health provider is not entitled to be 
     selected or retained by a health plan as a participating or 
     contracting provider whether or not such provider meets the 
     credentialing standards established under section 305.
       (B) Economic considerations.--If economic considerations, 
     including the health care provider's patterns of expenditure 
     per patient, are part of a selection decision, objective 
     criteria shall be used in examining such considerations and a 
     written description of such criteria shall be provided to 
     applicants, participating health providers, and enrollees. 
     Any economic profiling of health providers must be adjusted 
     to recognize case mix, severity of illness, and the age and 
     gender of patients of a health provider's practice that may 
     account for higher or lower than expected costs, to the 
     extent appropriate data in this regard is available to the 
     health plan.
       (4) Termination, reduction or withdrawal.--
       (A) Procedures.--A health plan shall develop and implement 
     procedures for the reporting, to appropriate authorities, of 
     serious quality deficiencies that result in the suspension or 
     termination of a contract with a health provider.
       (B) Review.--A health plan shall develop and implement 
     policies and procedures under which the plan reviews the 
     contract privileges of health providers who--

[[Page S1477]]

       (i) have seriously violated policies and procedures of the 
     health plan;
       (ii) have lost their privilege to practice with a 
     contracting institutional provider; or
       (iii) otherwise pose a threat to the quality of service and 
     care provided to the enrollees of the health plan.

     At a minimum, the policies and procedures implemented under 
     this subparagraph shall meet the requirements of the Health 
     Care Quality Improvement Act of 1986.
       (C) Communication.--Health plans shall not restrict nor 
     inhibit communication between providers and patients or 
     penalize a provider making public the failure of the health 
     plan to comply with the provisions of this Act.
       (D) Liability.--A health plan shall not require a provider 
     to sign any type of hold-harmless agreement as a requirement 
     for participation in the health plan.
       (E) Due process.--The policies and procedures implemented 
     under subparagraph (B) shall include requirements for the 
     timely notification of the affected health provider of the 
     reasons for the reduction, withdrawal, or termination of 
     privileges, and shall provide the health provider with the 
     right to appeal initially to the health plan and 
     subsequently, upon failure to resolve a dispute, to an 
     independent entity, the determination of reduction, 
     withdrawal, or termination. No reduction, withdrawal or 
     termination of privileges shall be made without cause.
       (F) Availability.--A written copy of the policies and 
     procedures implemented under this paragraph shall be made 
     available to a health provider on request prior to the time 
     at which the health provider contracts to provide services 
     under the plan.

     SEC. 307. CONFIDENTIALITY STANDARDS.

       (a) In General.--A health plan shall ensure that the 
     confidentiality of specified enrollee patient information and 
     records is protected.
       (b) Policies and Procedures.--A health plan shall have 
     written confidentiality policies and procedures. Such 
     policies and procedures shall, at a minimum--
       (1) protect the confidentiality of enrollee patient 
     information within the administrative structure of the health 
     plan with special attention to sensitive health conditions 
     and history;
       (2) protect health care record information;
       (3) protect claim information;
       (4) establish requirements for the release of information; 
     and
       (5) inform health plan employees of the confidentiality 
     policies and procedures and enforce compliance with such 
     policies and procedures.
       (c) Patient Care Providers and Facilities.--A health plan 
     shall ensure that providers, offices and facilities 
     responsible for providing covered items or services to plan 
     enrollees have implemented policies and procedures to prevent 
     the unauthorized or inadvertent disclosure of confidential 
     patient information to individuals who should not have access 
     to such information.
       (d) Release of Information.--An enrollee in a health plan 
     shall have the opportunity to approve or disapprove the 
     release of identifiable personal patient information by the 
     health plan, except where such release is required under 
     applicable law.

     SEC. 308. DISCRIMINATION.

       (a) Enrollees.--A health plan (network or non-network) may 
     not discriminate or engage (directly or through contractual 
     arrangements) in any activity, including the selection of 
     service area, that has the effect of discriminating against 
     an individual on the basis of race, culture, national origin, 
     gender, language, socio-economic status, age, disability, 
     health status including genetic information, or anticipated 
     utilization of health services.
       (b) Providers.--A health plan may not discriminate in the 
     selection of members of the health provider or provider 
     network (and in establishing the terms and conditions for 
     membership in the network) of the plan based on--
       (1) the race, national origin, culture, age or disability 
     of the health provider; or
       (2) the socio-economic status, disability, health status, 
     or anticipated utilization of health services of the patients 
     of the health provider.

     SEC. 309. PROHIBITION ON SELECTIVE MARKETING.

       A health plan may not engage in marketing or other 
     practices intended to discourage or limit the issuance of 
     health plans to individuals on the basis of health condition, 
     geographic area, industry, or other risk factors.
                   TITLE IV--MISCELLANEOUS PROVISIONS

     SEC. 401. ENFORCEMENT.

       (a) In General.--A State shall prohibit the offering or 
     issuance of any health plan in such State if such plan does 
     not--
       (1) have in place a utilization review program that is 
     certified by the State as meeting the requirements of title 
     II;
       (2) comply with the standards developed under title III;
       (3) have in place a credentialing program that meets the 
     requirements of section 305;
       (4) comply with the requirements of title IV; and
       (5) meet any other requirements determined appropriate by 
     the Secretary.
       (b) Self-Insured Plans.--The Secretary of Labor may take 
     corrective action to terminate or disqualify a self-insured 
     plan that does not meet the standards developed under this 
     subsection.

     SEC. 402. EFFECTIVE DATE.

       (a) In General.--Except as otherwise provided in this 
     section, this Act shall take effect on the date of enactment 
     of this Act.
       (b) Standards.--The standards and programs required under 
     this Act shall apply to health plans beginning on January 1, 
     1999.
       (c) Office for Consumer Information, Counseling and 
     Assistance with Health Care.--A State shall have in place the 
     Office required under section 101 on January 1, 1999. The 
     Secretary may award grants for the establishment of such 
     Offices beginning on the date of enactment of this Act.
       (d) Other Requirements.--The requirements of title IV shall 
     apply to health plans beginning on January 1, 1999.
       (e) Regulations.--The Secretaries described in section 
     301(a) may promulgate regulations to carry out this Act.

     SEC. 403. PREEMPTION.

       Nothing in this Act shall be construed to preempt any State 
     law, or the implementation of such a State law, that provides 
     protections for individuals that are equivalent to or 
     stricter than the provisions of this Act.
                                 ______
                                 
      By Mr. CLELAND (for himself, Mr. Coverdell, Ms. Moseley-Braun, 
        Mr. Reid, Mr. Hollings, Mr. Bingaman, Mr. Ford, Mr. Akaka, Mr. 
        Levin, Mr. Kerry, Mr. Conrad, Mr. Breaux, Mr. Lugar, Mr. Hagel, 
        Mr. Nickles, Mr. Rockefeller, Mr. Cochran, Mr. Leahy, Mr. 
        Thurmond, Mr. Bumpers, Mr. Lieberman, Mr. Warner, Mrs. 
        Hutchison, and Mr. Hutchinson):

  S. 347. A bill to designate the Federal building located at 100 
Alabama Street NW, in Atlanta, GA, as the ``Sam Nunn Federal Center''; 
to the Committee on Environment and Public Works.


                  sam nunn federal center legislation

 Mr. CLELAND. Mr. President, today, I honor Senator Sam Nunn, 
my friend, and one of America's most outstanding public servants. In 
recognition of the exceptional service Senator Sam Nunn has given to 
Georgia, the Senate, and the United States, I believe it would be 
fitting that the new Federal building in Atlanta be designated the 
``Sam Nunn Federal Center.''
  Senator Nunn has provided exemplary bipartisan leadership over the 
past 24 years, serving in a variety of leadership positions including 
both chairman and ranking member of the Senate Armed Services Committee 
and the chairman and ranking member on the Senate's Permanent 
Subcommittee on Investigations. In his years in the U.S. Senate, 
Senator Nunn earned the reputation as an internationally recognized 
expert on economic policy, defense, and national security.
  Respected and honored by both his colleagues and constituents, it has 
been said of Senator Nunn, ``Unlike some who gained prominence in the 
nation's capital, Nunn has not done so at the expense of his home base 
* * * Public events shift and change, but Sam Nunn keeps right on being 
Sam Nunn.'' First elected to the Senate in 1972, Sam Nunn has been one 
of the most admired and respected Members of the U.S. Senate and has 
consistently been ranked among the most effective Senators in surveys 
of journalists and congressional staffers.
  Senator Nunn has recently ended his many years of service as a U.S. 
Senator and I am deeply honored to now occupy his seat. I believe that 
naming the Federal building in Atlanta after Senator Nunn would be a 
permanent way in which we can appropriately recognize Senator Nunn's 
contributions to the Nation. I urge my fellow colleagues to join me in 
honoring my friend, and one of America's most admired public servants, 
and support the passage of the bill to designate the ``Sam Nunn Federal 
Center.'' In conclusion, I would like to have Senator Byrd's September 
27 floor statement made in tribute to Senator Nunn re-entered in the 
Record.
  Mr. President, I ask unanimous consent that additional material be 
printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

            [From the Congressional Record, Sept. 27, 1996]

                      Tribute to Senator Sam Nunn

       Mr. Byrd. Mr. President, we are rapidly approaching that 
     season when we shall witness the departure of many of our 
     colleagues who have elected not to serve beyond this 
     Congress.
       Mr. President, I was the 1,579th Senator of 1,826 men and 
     women who have served in the U.S. Senate from the beginning. 
     I have seen many fine Senators come and go. As I think

[[Page S1478]]

     back over the years, something good might well have been said 
     about most, if not all, of these Senators. We are prone, of 
     course, to deliver heartfelt eulogies, speeches declaring our 
     regrets that our colleagues choose to leave the service of 
     this body.
       About all of these Senators whom I have seen depart the 
     Senate, some good could be said, unlike Lucius Aelius 
     Aurelius Commodus, the Roman emperor who served from 180 to 
     192 A.D., one of the few Roman emperors about whom nothing 
     good could be said.
       I don't think that any of the Senators that I can recall at 
     the moment who voluntarily retired with honor from this body 
     were Senators about whom nothing good could be said. But 
     shortly, we will witness the departure of one of the truly 
     outstanding United States Senators of our time, and when I 
     say ``of our time,'' I mean my time as a Member of Congress 
     for 44 years, a Member of this body for 38 years. The 
     departure of Sam Nunn will be an irreparable loss. Someone 
     might be able to take his place over a period of years.
       I remember the death of Senator Russell, Richard Russell of 
     Georgia, on January 21, 1971, 25 years ago. In the course of 
     those 25 years, one-quarter of a century, I have to say that 
     I have not seen the likeness of Richard Russell, except in 
     Senator Samuel Augustus Nunn.
       So it may be another 25 years, it may be 50 years before we 
     see the likeness of Senator Nunn.
       I pay tribute to this distinguished colleague who is 
     retiring from the Senate after 24 years--illustrious years. 
     There are many things that one can say about Sam Nunn, as he 
     has been consistently productive, growing in stature year by 
     year to become, without doubt, the leading Senate voice on 
     national defense security and alliance issues--the leading 
     voice. His accomplishments, of which there are many, are 
     notable and derive from an approach to his work which is 
     unfailingly thorough and well-focused. He is blessed with an 
     exceptional intellect, and in Senator Nunn's case that sharp 
     intellect combines with a much rarer talent for harnessing 
     creative visions to practical techniques. Sam Nunn has been 
     especially successful as a legislator in this body because of 
     his ability to reduce complicated issues to an understandable 
     scope, while avoiding oversimplification. Then he works 
     patiently and persistently to build bipartisan support.
       Indeed, his many ideas and initiatives are often shared and 
     supported by his colleagues across the aisle. In a day when 
     bipartisanship is as rare as platinum and gold and rubies, 
     and certainly as valuable, Sam Nunn epitomizes that for which 
     so many of us strive, and often fail to achieve--bipartisan 
     consensus which the people so desire and which fuels large 
     majorities behind legislative endeavors. The ingredients of 
     vision coupled with practicality, and balance between liberal 
     and conservative views, mark his spectacularly successful 
     career as a Senator and are textbook examples for the younger 
     Members of this body and the newer Members of this body in 
     the years to come to heed and to emulate.
       Sam Nunn hails from Georgia, where commitment to the 
     Nation's defense runs deeply, and from whence some of our 
     greatest legislators on national defense have emerged. He has 
     upheld the great Georgia tradition so ably begun by his 
     granduncle Representative Carl Vinson, with whom I served in 
     the House of Representatives before coming to the Senate, and 
     his predecessor, Senator Richard B. Russell.
       While Senator Nunn has only served as the chairman or 
     ranking member of the Armed Services Committee for 12 years, 
     his record of achievement and the reverence in which he is 
     held in this body are comparable to that--and I know--
     comparable to that of the great Russell. This is a feat of 
     enormous distinction. The State of Georgia has to be 
     extremely proud to have given such talented sons to our 
     Republic, men who have so well borne the mantle of 
     responsibility to protect the defense of our Nation and 
     promote its fighting forces.
       Now, if you ask Sam Nunn what he regards as the most 
     important of his many, many achievements in affecting and 
     directing U.S. policy in the national defense arena, I 
     doubt--and I have never asked him this question--but I doubt 
     that he would mention the more widely publicized of his 
     achievements, such as his role in developing the Stealth 
     fighter; or the many initiatives he authored to reduce the 
     dangers of war in the Russian-American relationship; or the 
     meaningful measures enacted to reduce and make safer the 
     world's inventories of nuclear weapons and fissile materials; 
     or even his role in broadening and deepening American 
     leadership in NATO, in Bosnia, in the Persian Gulf, or in 
     Haiti. It is in the less heralded, less glamorous but 
     critically important area of the morale and welfare of our 
     men and women in uniform that is at the top of the list that 
     Sam Nunn might himself cite as his most noteworthy 
     achievement in the defense area.
       Senator Nunn was the key player in meeting the needs of the 
     All Volunteer Force so that we could attract and retain the 
     kind of men and women who could effectively manage and lead 
     our forces across the globe in all environments. He 
     constructed a benefits package for the men and women who 
     fought so well in the Kuwait Desert in Operation Desert 
     Storm. He crafted the post-cold war transition measures that 
     address the needs of our military personnel as they make 
     their way from the front lines of the cold war back into 
     American civilian society.
       He has worked tirelessly to instill a sense of pride and 
     loyalty in our uniformed men and women that is of such great 
     value to the Nation. As Edmund Burke said on March 22, 1775, 
     ``It is the love of the people; it is their attachment to 
     their government, from the sense of the deep stake they have 
     in such a glorious institution, which gives you your army and 
     navy, and infuses in both that liberal obedience, without 
     which your army would be a base rabble, and your navy nothing 
     but rotten timber.''
       Now I have been privileged to serve with Sam Nunn as a 
     member of the Armed Services Committee and with Sam Nunn as 
     its leader. Senators are not renowned for their managerial 
     skills, but the Armed Services Committee under Sam Nunn's 
     leadership has been superbly managed.
       In my 44 years in Congress, I have yet to see a chairman of 
     any committee who excelled Sam Nunn. In my humble judgment, 
     he is the best committee chairman that I have ever seen in 
     these 44 years in Congress, including myself. I worked hard 
     at being a good chairman. But Senator Nunn, to me, represents 
     the ideal, the model, the paragon of excellence as a 
     chairman.
       Unusual among authorization committees in the Senate, he 
     produced, from 1987 through 1994, eight straight 
     authorization acts, each of which continued major initiatives 
     to build a better managed, sounder Department of Defense. He 
     was the key figure behind the so-called Goldwater-Nichols 
     Reorganization Act, which decentralized power in the armed 
     services, giving more on-the-ground authority to our unified 
     commanders in the geographic areas where they had to prepare 
     forces to fight in various contingencies. He developed the 
     legislation which produced the Defense Base Closure and 
     Realignment Commission, which cut through the political 
     snarls involved in closing bases, and has been a most 
     effective tool in downsizing the DOD establishment in a fair 
     and orderly way.
       Over the years our uniformed leaders have consistently 
     looked to Sam Nunn as their champion, as a strong but 
     sensitive force, who empathized with their special needs and 
     could be counted on to take the kind of action appropriate to 
     best enhance the morale of the men under their command. He 
     did not fail them.
       Perhaps some of the most creative ideas that Sam Nunn 
     willed into reality came in the knotty area of reducing the 
     quantum of danger in the Russian-American relationship. He 
     championed, together with John Warner, programs to increase 
     communication between the American and Russian leadership, 
     and thus reduce the possibilities of tragic, accidental 
     nuclear war. Together with Richard Lugar, he crafted a 
     successful program to dismantle nuclear weapons possessed by 
     the states of the former Soviet Union. He led the Senate Arms 
     Control Observer Group for many years, as my appointee to 
     that group when I was Majority Leader, traveling frequently 
     to Geneva, leading delegations of Senators to ensure that 
     progress on the INF and START Treaties had the knowledge and 
     support of the United States Senate. He traveled extensively 
     to Russia, and in turn Russian legislative leaders traveled 
     to the United States, to exchange views and develop 
     cooperative solutions to problems, thereby increasing the 
     level of confidence and understanding between these two 
     superpowers. Lately he has developed additional initiatives, 
     again with a leading Republican counterpart, Senator 
     Domenici, to tackle the problem of terrorist actions against 
     the United States. All in all, Sam Nunn, when he leaves this 
     Chamber and walks out of this door for the last time as a 
     Member of this body, can take immense pride in his long, 
     intense and patient efforts in the superpower relations 
     arena. Those hard-won initiatives have had a substantial 
     impact on the measure of safety in our world. It is indeed no 
     exaggeration to say that the world today is a safer place in 
     part because of the monumental efforts of one man, the senior 
     Senator from the State of Georgia--Sam Nunn.
       These achievements and the quality of his dedication and 
     work on defense, alliance and international issues, ranging 
     from NATO to arms control and reduction, anti-terrorism, and 
     joint U.S.-Russian threat reduction and communications 
     measures have propelled his glorious reputation far beyond 
     the Senate. He is known internationally and he is viewed 
     universally as an expert in the defense field. He is well 
     known in official circles around the globe and is widely 
     sought for his wise counsel.
       Is it not remarkable that in my time there would have been 
     two chairmen of the Senate Armed Services Committee, two 
     ``tall men, who lived above the fog in public duty and in 
     private thinking''--Senator Richard Russell and Senator 
     Samuel Nunn--both experts in the field of national defense. 
     Both of whom sought for their wise counsel,--sought out on 
     this floor,--sought out before the bar of the Senate, in the 
     well, sought out in foreign capitals for their wise counsel.
       It is not an overstatement to say Sam Nunn's reach and 
     impact have been international and characterized by workable, 
     sound proposals and brilliant judgment. The global scope of 
     his work has set him apart from the vast majority of men who 
     have served in this body and is a testimony to his dedication 
     to the addressing of the burning issues of sanity and order 
     in our world today.
       While Sam Nunn will undoubtedly be remembered for his 
     Senate service in the area

[[Page S1479]]

     of national defense, as if that were not enough, his energy 
     and creativity have also been evident in many other areas. 
     The range of his thinking and his talents as a legislator and 
     policy maker encompass everything from health care, to 
     student loans, to insurance industry reform. In his farewell 
     address, announcing his retirement, in Georgia on October 9, 
     1995, he dwelled extensively on the need for America to put 
     our youth first, to work on protecting our children from 
     street violence and drugs. He spoke eloquently of the need to 
     reverse the saturation of our TV airwaves with programs of 
     sex and violence. He focused on the need to reinvigorate our 
     educational system in order to reincorporate great numbers of 
     American citizens back into the working culture of our 
     nation. He has developed successful legislation to lay the 
     groundwork for a nationwide ``civilian service corps'' by 
     offering education benefits in exchange for public service. 
     As the cochairman of the Strengthening of America Commission, 
     a bipartisan group of business, educational, labor and 
     academic leaders, he has proposed an impressive plan to make 
     radical changes in the income tax code to refocus our economy 
     on savings and investment and away from consumption.
       Most importantly, and as my fellow Senators well know, Sam 
     Nunn's success is in large part attributable to his hard rock 
     integrity.
       A religious man, he does not go around wearing his religion 
     on his sleeve; he does not go around making a big whoop-de-do 
     about his religion, but he is a religious man, a moral man. 
     Sam Nunn is known as a man whose judgment can be trusted. How 
     many times have I heard Senators come to the Senate floor to 
     vote on a measure and ask: ``How is Sam voting on this one?'' 
     He is a leader in this body, in spite of the fact that he has 
     not especially sought to lead. He has not been elected to a 
     leadership position, but he has grown into a leadership 
     position. He is a natural leader. His is the best type of 
     leadership, because it is a leadership that is born of strong 
     character. Horace Greeley said: ``Fame is a vapor; popularity 
     an accident; riches take wings. Those who cheer today, may 
     curse tomorrow. Only one thing endures: character.''
       Sam Nunn epitomizes that great trait, character. The Senate 
     will feel the loss of Sam Nunn and feel it deeply. His legacy 
     and achievements certainly will grow with time. I am 
     personally deeply sorry that he has chosen to go. He will 
     leave an empty place in the Senate.
       Napoleon rejoiced that the ``bravest of the brave,'' 
     Marshal Ney, had escaped and had returned across the Dnieper 
     River, even though he had lost all of his cannons. Napoleon 
     ordered that there be a salute to celebrate the escape and 
     the return of Ney. And he said, ``I have more than 400 
     million francs in the cellar of the Tuileries in Paris, and I 
     would have gladly given them all for the ransom of my old 
     companion in arms.''
       Had Sam Nunn been an officer in the Grand Army of France, 
     Napoleon would have given everything he possessed for another 
     Sam Nunn.
       His great natural talents will continue to bring him to the 
     forefront of the national policy discussion, and he will, I 
     know, continue to achieve great things in a variety of new 
     settings.
       I have never really felt about a man in the Senate--other 
     than Senator Richard Russell--as I have felt about Sam Nunn. 
     I was the majority whip in the Senate when Sam Nunn came to 
     the Senate, and I urged that he be placed on the Senate Armed 
     Services Committee. As a member of the Steering Committee, I 
     cast my vote to put Sam Nunn on that committee. That is where 
     he wanted to serve. I watched him grow. I have had some 
     differences, from time to time--minor, of course--with Sam on 
     some issues. That is not the point. Sam has fulfilled my idea 
     of what a Senator ought to be.
       There were 74 delegates chosen to attend the Constitutional 
     Convention. The Convention met behind closed doors from May 
     25 to September 17, 1787. Fifty-five of those 74 delegates 
     who were chosen participated, and 39 of the 74 signed the 
     Constitution of the United States. I can see in my mind's eye 
     a Sam Nunn in that gallery. I might well imagine that, as 
     they met from day to day, if Sam Nunn had been a participant, 
     they would have come, as they come here when Members of this 
     body gather in the well, and asked, ``What does Sam Nunn 
     think about this?'' I have no difficulty in imagining that. 
     In such an august gathering as was that Convention, which sat 
     in 1787, with George Washington, the Commander in Chief at 
     Valley Forge and the soon-to-be first President of the United 
     States, I can imagine that it would have been the same there. 
     They would have said, ``What does Sam Nunn think? How is he 
     going to vote?''
       The First Congress was to have convened on March 4, 1789. 
     And only 8 Senators--less than a quorum--of the 22 were there 
     on March 4, 1789. Five States were represented--New 
     Hampshire, Connecticut, Massachusetts, Pennsylvania, and 
     Georgia. And the Senator from Georgia who attended that day 
     was William Few.
       It could very well have been Sam Nunn as a Member of that 
     first Senate, serving with Oliver Ellsworth, Maclay and 
     Morris, and others. And as they met to blaze the pioneer 
     paths of this new legislative body, the U.S. Senate, I have 
     no problem in imagining that, often, those men would have 
     turned to Sam Nunn and said, ``How are you going to vote, 
     Sam?'' ``How is Sam going to vote?''
       I think every Member of this body shares with me that 
     feeling about Sam Nunn. He could have been an outstanding 
     U.S. Senator at any time in the history of this Republic--not 
     this democracy. When the Convention completed its work, a 
     lady approached Benjamin Franklin and said, ``Dr. Franklin, 
     what have you given us?'' He didn't answer, ``A democracy, 
     Madam.'' He said, ``A republic, Madam, if you can keep it.''
       Now, what is there about Sam Nunn that makes him this kind 
     of man? He is not the typical politician that one conjures up 
     in his mind when thinking about Senators and other 
     politicians. Senator Nunn is not glib. He doesn't jump to 
     hasty conclusions.
       He does not rush to be ahead of all of the other Senators 
     so that he will get the first headline. He thinks about the 
     problem, and he logically, methodically, and systematically 
     arrives at a decision. Then he carefully prepares to put that 
     decision into action.
       I suppose that had he lived at the time of Socrates, who 
     lived during the chaos of the great Peloponnesian wars, Sam 
     would have been out there in the marketplace debating with 
     Socrates, about whom Cicero said he ``brought down philosophy 
     from Heaven to Earth.'' Sam would have been a hard man for 
     Socrates to put down because he has that talent, that knack 
     of thinking, an organized thinking, and the consideration of 
     a matter logically, carefully, and thoroughly. He is truly a 
     man for all seasons. His wisdom, his judgment, and his 
     statesmanship have reflected well on the profession of public 
     service at a time when fierce ``take-no-prisoners politics'' 
     has embroiled the Nation to alarming degrees.
       Napoleon did not elect to go into Spain, and Wellington was 
     concerned that Napoleon himself might lead. Wellington later 
     told Earl Stanhope that Napoleon was superior to all of his 
     marshals and that his presence on the field was like 40,000 
     men in the balance. Sam Nunn, the 1,668th Senator to appear 
     on this legislative field of battle, is like having a great 
     number in array against or for your position.
       I was looking just this morning over the names of those 
     Senators who are leaving, and examining their votes on what 
     is called pejoratively the Legislative Line-Item Veto Act of 
     1995. Of those Senators who are leaving, seven voted against 
     that colossal monstrosity, for which many of those who voted 
     will come to be sorry. If this President is reelected, he 
     will have it within his power to make them sorry. He is just 
     the man who might do it.
       Among the departing Senators, Sam Nunn is one of those who 
     opposed that bill. Senator Heflin, Senator Johnston, Senator 
     Pell, Senator Pryor, Senator Cohen, Senator Hatfield, and 
     Senator Nunn voted, to their everlasting honor, against that 
     miserable piece of junk.
       Just wait until this President exercises that veto and see 
     how they come to heel--h-e-e-l. They will rue the day. But 
     Sam Nunn voted against it.
       For the outstanding quality of his character as well as for 
     the brilliance of his service, this Senate and the Nation are 
     eternally in his debt. He will always command, in my heart 
     and in my memory, a place with Senator Richard Russell.

     God, give us men. A time like this demands
     Strong minds, great hearts, true faith, and ready hands;
     Men whom the lust of office does not kill;
     Men whom the spoils of office cannot buy;
     Men who possess opinions and a will;
     Men who have honor; men who will not lie;
     Men who can stand before a demagog
     And damn his treacherous flatteries without winking.
     Tall men, sun-crowned, who live above the fog
     In public duty and in private thinking;
     For while the rabble, with their thumb-worn creeds,
     Their large professions and their little deeds,
     Mingle in selfish strife, lo. Freedom weeps,
     Wrong rules the land and waiting justice sleeps.
     God give us men.
     Men who serve not for selfish booty,
     But real men, courageous, who flinch not at duty.
     Men of dependable character; men of sterling worth.
     Then wrongs will be redressed and right will rule the earth.
     God, give us men.

       Men like Samuel Augustus Nunn.

                          ____________________