[Congressional Record Volume 145, Number 50 (Tuesday, April 13, 1999)]
[Senate]
[Pages S3642-S3652]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
Patients' Telephone Privacy Act
Mrs. FEINSTEIN. Mr. President, today I introduce a bill to protect
the medical privacy rights of patients when they talk to their health
care insurers or providers. The bill requires health care insurers and
providers to obtain patients' ``express consent'' before tape-recording
or monitoring conversations.
Today, the health insurance industry routinely tape-records and
monitors incoming telephone calls of patients with questions about
their health insurance coverage. This bill halts that common practice
with two simple rules.
First, health insurance companies and health care providers must
obtain the patient's ``express consent'' before tape-recording or
monitoring a conversation. Second, health insurance companies and
health care providers must give patients the option not to be tape-
recorded or monitored.
[[Page S3643]]
The bill puts control of medical privacy back where it belongs--in
the hands of patients who have no choice but to share personal
information with their health insurance and health care providers.
The bill protects all patients--
Whether covered by private or public health plans,
Whether covered by group, individual, or self-insured health plans,
Whether covered by Medicare or Medicaid,
Whether covered by Federal health plans, or
Whether covered by the Children's Health Insurance Plan.
Let me emphasize again who would be subject to the bill--the health
insurance and health care industry--a huge industry that necessarily
affects all of us. First, the bill would cover communications between
patients and health insurers. Second, the bill would cover
communications between patients and ``health care providers,'' which
includes physicians and other health care professionals.
Federal law now requires that only one party must consent to the
tape-recording or monitoring of a telephone conversation. In
California, state law provides that all parties must consent before a
telephone conversation may be tape-recorded. Nearly a dozen other
states have adopted similar two-party consent laws. They include
Delaware, Florida, Illinois, Kansas, Maryland, Massachusetts, Michigan,
Montana, New Hampshire, Pennsylvania, and Washington.
Even two-party consent laws, however, do not adequately address this
problem. Health insurance companies tape-record or monitor patients'
calls based on the patient's implied consent. Implied consent arises
from the patient talking after hearing the health insurer's recording
that the call may be tape-recorded or monitored. In this case, courts
have held that consent is given implicitly.
Consequently, merely changing federal law to a two-party consent rule
would not solve the problem. The key requirement must be that the
health insurer or health care provider obtains the patient's express
consent. Only this change will protect individuals when they call their
health insurance provider with questions about their health care
coverage. When my office contacted the top 100 health insurance
providers in this country, we learned from nearly all who responded
that they routinely monitor or tape-record calls received from
patients.
Let me share with my colleagues some responses that we received.
Kaiser Permanente operates in nineteen states and the District of
Columbia, and provides care to more than nine million members. Their
practice varies from state to state, depending on applicable state
laws.
Kaiser Permanente may: Monitor randomly selected calls, in which case
it may, or may not, notify patients in advance; or tape-record all or
randomly selected calls, in which case it may, or may not, notify
patients in advance.
United HealthCare wrote to me that they did not believe that tape-
recording or monitoring calls even presents a privacy issue. Their
rationale was that they only randomly tape-record calls and only after
advising the caller that they may record the call.
Great-West responded that a patient has the option of communicating
in writing if the patient does not want a telephone call to be tape-
recorded. Let me say simply--that is not good enough for me. Imagine
the undue burden the task of writing a letter may place on elderly or
seriously ill patients.
Despite the two-party consent rule in California, New York Life Care
Health Plans, Inc., asserted that no violation of California law occurs
without a ``confidential communication.'' Under California state law,
the definition of a ``confidential communication'' does not include
communications where the parties may expect that the may be recorded.
New York Life asserted that, since they told patients that their calls
could be monitored, their calls were not confidential calls.
New York Life's display of legal bootstrapping shows little, if any,
regard for medical privacy rights. Their interpretation of the word
``confidential'' turns its commonly understood meaning on its head! In
the minds of most people, what could be more confidential than matters
about one's personal health problems? Surely little, if anything. How
many of my colleagues in the Senate would say that communications about
their health problems with health insurance or health care providers
are not confidential?
Blue Cross Blue Shield of the National Capital Area does not give
patients any notice that their calls may be monitored. Their Associate
General Counsel responded that, in both Maryland and the District of
Columbia, telephone communications in the normal course of business do
not meet the definition of an ``interception.'' Thus, consent is not
required. Although Virginia law considers a telephone to be an
``intercepting device,'' Virginia follows the one-party consent rule.
Finger Lakes Blue Cross Blue Shield randomly tape-records calls from
patients and only now is setting up a front-end recording to inform
patients of that practice. New York requires only one party to consent.
None of the health insurance providers who responded to my office
gave me a valid reason for tape-recording or monitoring patients'
calls. The standard response from health insurers was that they tape-
record or monitor patients' calls for so-called ``quality control,'' an
ambiguous term at best. Indeed, no one explained what that term means,
how tape-recording calls benefits patients, or why tape-recording calls
was necessary.
Of course, health insurance providers are not the only business
entities that tape-record telephone conversations. How many of us
realize that when we call for airline tickets, bank account
information, mutual fund transfers, or any myriad of other daily
concerns, the other party on the telephone line will be tape-recording
the conversation? Yet, personal health information is far more personal
in nature and, accordingly, entitled to greater protection. It stands
alone as uniquely different from other commercial transactions.
This bill does not attempt to change the consent rule for other
business entities. It would apply only to health insurance and health
care providers. Most patients today have almost no choice about their
health insurer provider or, increasingly, about their health care
provider. In turn, the health insurer may give the patient no option
except to submit to tape-recording the conversation. An elderly, or
seriously ill patient, is simply not going to object.
Admittedly, much disclosure of medical information occurs both with
patient consent and for valid medical reasons. For instance, insurance
companies receive information from physicians based upon a written
consent form signed by the patient at the physician's request. Yet,
increasingly, threats to medical health privacy have become less
visible and, in that sense, more alarming. Many individuals are left
with a false sense of privacy. The potential for misuse of personal
health information is real and growing.
A fundamental right to medical privacy is embedded in American
society. Most Americans presume that telephone conversations about
their health problems are confidential. Sadly, they are wrong.
Conversations with our health insurance and health care providers
often contain deeply personal information, including prescription
drugs, psychiatric care, alcohol dependency--the list goes on and on.
Surely they deserve protection. Traditionally, Americans have relied
upon a confidential relationship with their doctors.
Let's restore at least some measure of protection to telephone
conversations about our personal health problems. This bill allows
health insurance and health care providers to continue their routine
practice of tape-recording or monitoring patients' calls--but only with
the patient's express consent.
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. 182
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Patients' Telephone Privacy
Act of 1999''.
SEC. 2. MODIFICATION OF EXCEPTION TO PROHIBITION ON
INTERCEPTION OF COMMUNICATIONS.
(a) Modification.--Section 2511(2)(d) of title 18, United
States Code, is amended--
[[Page S3644]]
(1) by striking ``It shall not be unlawful'' and inserting
``(i) Subject to clause (ii), it shall not be unlawful''; and
(2) by adding at the end the following:
``(ii)(I) With respect to a wire, oral, or electronic
communication between a health insurance issuer or health
plan and an enrollee of such health insurance issuer or
health plan, or between a health care provider and a patient,
it shall not be unlawful under this chapter for a health
insurance issuer, health plan, or health care provider to
intercept such communication only if the patient has given
prior express consent to such interception.
``(II) In this paragraph--
``(A) the term `health insurance issuer' has the meaning
given that term in section 733 of the Employee Retirement
Income Security Act of 1974 (29 U.S.C. 1191b);
``(B) the term `health plan' means a group health plan, as
defined in section 733 of the Employee Retirement Income
Security Act of 1974 (29 U.S.C. 1191b), an individual or
self-insured health plan, the medicare program under title
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.),
the medicaid program under title XIX of such Act (42 U.S.C.
1396 et seq.), the State children's health insurance program
under title XXI of such Act (42 U.S.C. 1397aa et seq.), the
Civilian Health and Medical Program of the Uniformed Services
under chapter 55 of title 10, and a health plan offered under
chapter 89 of title 5; and
``(C) the term `health care provider' means a physician or
other health care professional.''.
(b) Recording and Monitoring of Communications with Health
Insurers.--
(1) Communication without recording or monitoring.--
Notwithstanding any other provision of law, a health
insurance issuer, health plan, or health care provider that
notifies any customer of its intent to record or monitor any
communication with such customer shall provide the customer
the option to conduct the communication without being
recorded or monitored by the health insurance issuer, health
plan, or health care provider.
(2) Definitions.--In this subsection:
(A) Health care provider.--The term ``health care
provider'' means a physician or other health care
professional.
(B) Health insurance issuer.--The term ``health insurance
issuer'' has the meaning given that term in section 733 of
the Employee Retirement Income Security Act of 1974 (29
U.S.C. 1191b).
(C) Health plan.--The term ``health plan'' means--
(i) a group health plan, as defined in section 733 of the
Employee Retirement Income Security Act of 1974 (29 U.S.C.
1191b);
(ii) an individual or self-insured health plan;
(iii) the medicare program under title XVIII of the Social
Security Act (42 U.S.C. 1395 et seq.);
(iv) the medicaid program under title XIX of such Act (42
U.S.C. 1396 et seq.);
(v) the State children's health insurance program under
title XXI of such Act (42 U.S.C. 1397aa et seq.);
(vi) the Civilian Health and Medical Program of the
Uniformed Services under chapter 55 of title 10, United
States Code; and
(vii) a health plan offered under chapter 89 of title 5,
United States Code.
(c) Effective Date.--The amendments made by this Act shall
take effect on the date that is 60 days after the date of
enactment of this Act.
______
By Mrs. FEINSTEIN (for herself, and Mr. Sessions):
S. 783. A bill to limit access to body armor by violent felons and to
facilitate the donation of Federal surplus body armor to State and
local law enforcement agencies; to the Committee on the Judiciary.
James Guelff Body Armor Act of 1999
Mrs. FEINSTEIN. Mr. President, I am pleased today to introduce the
James Guelff Body Armor Act of 1999.
Currently, Federal law does not limit access to body armor for
individuals with even the grimmest history of criminal violence.
However, it is unquestionable that criminals with violent intentions
are more dangerous when they are wearing body armor.
Many will recall the violent and horrific shootout in North
Hollywood, California, just two years ago. In that incident, two
suspects wearing body armor and armed to the teeth, terrorized a
community. Police officers on the scene had to borrow rifles from a
nearby gunshop to counteract the firepower and protective equipment of
these suspects.
Another tragic incident involves San Francisco Police Officer James
Guelff, for whom this act is named. On November 13, Officer Guelff
responded to a distress call. Upon reaching the crime scene, he was
fired upon by a heavily armed suspect who was shielded by a kevlar vest
and bulletproof helmet. Officer Guelff died in the ensuing gun-fight.
Lee Guelff, James Gueff's brother, recently wrote a letter to me
about the need to revise the laws relating to body armor. He wrote:
It's bad enough when officers have to face gunmen in
possession of superior firepower . . . But to have to
confront suspects shielded by equal or better defensive
protection as well goes beyond the bounds of acceptable risk
for officers and citizens alike. No officer should have to
face the same set of deadly circumstances again.
I couldn't agree with Lee more. Our laws need to recognize that body
armor in the possession of a criminal is an offensive weapon. We need
to make sure that our police officers on the streets are adequately
supplied with body armor, and that hardened-criminals are deterred from
using body armor.
The James Guelff Body Armor Act of 1999 has three key provisions to
achieve these goals. First, it increases the penalties criminals
receive if they commit a crime wearing body armor. Specifically, a
violation will lead to an increase of two levels under the Federal
sentencing guidelines. Second, it makes it unlawful for violent felons
to purchase, use, or possess body armor. Third, this bill enables
Federal law enforcement agencies to directly donate surplus body armor
to local police.
I will address each of these three provisions.
Enhancing criminal penalties for individuals who wear body armor
during the commission of a crime: Criminals who wear body armor during
the commission of a crime should face enhanced penalties because they
pose an enhanced threat to police and civilians alike. Assailants
shielded by body armor can shoot at the police and civilians with less
fear than individuals not so well protected.
In the North Hollywood shoot-out, for example, the gunmen were able
to hold dozens of officers at bay because of their body armor. This
provision will deter the criminal use of body armor, and thus deter the
escalation of violence in our communities
Making it unlawful for violent felons to wear body armor: This bill
makes it a crime for individuals with a violent criminal record to wear
body armor. It is unconscionable that criminals can obtain and wear
body armor without restriction when so many of our police lack
comparable protection.
The bill recognizes that there may be exceptional circumstances where
an individual with a brutal history legitimately needs body armor to
protect himself or herself. Therefore, it provides a mechanism for
violent felons to obtain specific permission from the Secretary of the
Treasury to wear body armor.
This provision has already been codified into law in California.
Several other states are also actively considering legislation to
restrict violent felons access to body armor.
California police applied the law for the first time earlier this
year. Police arrested an individual for wearing body armor who had a
violent criminal record. Besides a conviction for second-degree assault
in 1993, the suspect is independently facing charges for threatening to
kill his ex-girlfriend. He also is facing trial for issuing death
threats against security guards at a West Hollywood Nightclub.
Direct donation of body armor: The James Guelff Body Armor Act of
1999 speeds up the procedures by which Federal agencies can donate
surplus body armor to local police.
It is disturbing that so many of our local police officers do not
have access to bullet-proof vests. The United States Department of
Justice estimates that 25% of State, local, and tribal law enforcement
officers, approximately 150,000 officers, are not issued body armor.
Getting our officers more body armor will save lives. According to
the Federal Bureau of Investigation, greater than 30% of the 1,182
officers killed by guns in the line of duty since 1980 could have been
saved by body armor, and the risk of dying from gunfire is 14 times
higher for an officer without a bulletproof vest.
Last year, Congress made some inroads into this shortage of body
armor by enacting the ``Bulletproof Vest Partnership Grant Act of
1998.'' This act established a $25 million annual fund to help local
and State police purchase body armor. The James Guelff Body Armor Act
of 1999 will provide a further boost to the body armor resources of
local and State police departments.
This legislation has attracted the support of a broad cross-section
of the
[[Page S3645]]
law enforcement community. The Fraternal Order of Police, the National
Association of Police Organizations, the National Sheriffs'
Association, the National Troopers Coalition, the International
Association of Police Chiefs, the Federal Law Enforcement Officers
Association (FLEOA), the Police Executive Research Forum, the
International Brother of Police Officers, and the National Association
of Black Law Enforcement Executives, have all endorsed the legislation.
Richard J. Gallo, President of the Federal Law Enforcement Officers
Association notes:
In the past, FLEOA members have confronted individuals,
with prior criminal convictions, wearing body armor and
violently resisting arrest. Federal, state and local law
enforcement officers, and the public, deserve protection from
this, and at the very least, will now know theses felons will
receive enhanced sentences for using body armor during the
commission of a criminal act.
Robert Stewart, Executive Director of the National Organization of
Black Law Enforcement Executives, writes:
There is a societal obligation to assure the men and women
in blue are afforded all the protection they need to maintain
public order. Very real fiscal constraints can, however,
compromise the ability of local governments to accomplish
that critical goal. Hence, NOBLE heartily endorses the James
Guelff Body Armor Act of 1999.
I look forward to working with my fellow Senators from both sides of
the aisle in turning this bill into law.
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. 783
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``James Guelff Body Armor Act
of 1999''.
SEC. 2. FINDINGS.
Congress finds that--
(1) nationally, police officers and ordinary citizens are
facing increased danger as criminals use more deadly
weaponry, body armor, and other sophisticated assault gear;
(2) crime at the local level is exacerbated by the
interstate movement of body armor and other assault gear;
(3) there is a traffic in body armor moving in or otherwise
affecting interstate commerce, and existing Federal controls
over such traffic do not adequately enable the States to
control this traffic within their own borders through the
exercise of their police power;
(4) recent incidents, such as the murder of San Francisco
Police Officer James Guelff by an assailant wearing 2 layers
of body armor and a 1997 bank shoot out in north Hollywood,
California, between police and 2 heavily armed suspects
outfitted in body armor, demonstrate the serious threat to
community safety posed by criminals who wear body armor
during the commission of a violent crime;
(5) of the approximately 1,200 officers killed in the line
of duty since 1980, more than 30 percent could have been
saved by body armor, and the risk of dying from gunfire is 14
times higher for an officer without a bulletproof vest;
(6) the Department of Justice has estimated that 25 percent
of State and local police are not issued body armor;
(7) the Federal Government is well-equipped to grant local
police departments access to body armor that is no longer
needed by Federal agencies; and
(8) Congress has the power, under the interstate commerce
clause and other provisions of the Constitution of the United
States, to enact legislation to regulate interstate commerce
that affects the integrity and safety of our communities.
SEC. 3. DEFINITIONS.
In this Act:
(1) Body armor.--The term ``body armor'' means any product
sold or offered for sale, in interstate or foreign commerce,
as personal protective body covering intended to protect
against gunfire, regardless of whether the product is to be
worn alone or is sold as a complement to another product or
garment.
(2) Law enforcement agency.--The term ``law enforcement
agency'' means an agency of the United States, a State, or a
political subdivision of a State, authorized by law or by a
government agency to engage in or supervise the prevention,
detection, investigation, or prosecution of any violation of
criminal law.
(3) Law enforcement officer.--The term ``law enforcement
officer'' means any officer, agent, or employee of the United
States, a State, or a political subdivision of a State,
authorized by law or by a government agency to engage in or
supervise the prevention, detection, investigation, or
prosecution of any violation of criminal law.
SEC. 4. AMENDMENT OF SENTENCING GUIDELINES WITH RESPECT TO
BODY ARMOR.
(a) Sentencing Enhancement.--The United States Sentencing
Commission shall amend the Federal sentencing guidelines to
provide an appropriate sentencing enhancement, increasing the
offense level not less than 2 levels, for any offense in
which the defendant used body armor.
(b) Applicability.--No amendment made to the Federal
Sentencing Guidelines pursuant to this section shall apply if
the Federal offense in which the body armor is used
constitutes a violation of, attempted violation of, or
conspiracy to violate the civil rights of any person by a law
enforcement officer acting under color of the authority of
such law enforcement officer.
SEC. 5. PROHIBITION OF PURCHASE, USE, OR POSSESSION OF BODY
ARMOR BY VIOLENT FELONS.
(a) Definition of Body Armor.--Section 921 of title 18,
United States Code, is amended by adding at the end the
following:
``(35) The term `body armor' means any product sold or
offered for sale, in interstate or foreign commerce, as
personal protective body covering intended to protect against
gunfire, regardless of whether the product is to be worn
alone or is sold as a complement to another product or
garment.''.
(b) Prohibition.--
(1) In general.--Chapter 44 of title 18, United States
Code, is amended by adding at the end the following:
``Sec. 931. Prohibition on purchase, ownership, or possession
of body armor by violent felons
``(a) In General.--Except as provided in subsection (b), it
shall be unlawful for a person to purchase, own, or possess
body armor, if that person has been convicted of a felony
that is--
``(1) a crime of violence (as defined in section 16); or
``(2) an offense under State law that would constitute a
crime of violence if it occurred within the special maritime
and territorial jurisdiction of the United States.
``(b) Exception.--
``(1) Application.--A person who is subject to the
prohibition of subsection (a) whose employment, livelihood,
or safety is dependent on the ability to possess and use body
armor, may file a petition with the Secretary for an
exception to the prohibition of subsection (a).
``(2) Action by secretary.--Upon receipt of a petition
under paragraph (1), the Secretary may reduce or eliminate
the prohibition of subsection (a), impose conditions on
reduction or elimination of the prohibition, or otherwise
grant relief from the prohibition, as the Secretary
determines to be appropriate, based on a determination that
the petitioner--
``(A) is likely to use body armor in a safe and lawful
manner; and
``(B) has a reasonable need for such protection under the
circumstances.
``(3) Factors for consideration.--In making a determination
under paragraph (2) with respect to a petitioner, the
Secretary shall consider--
``(A) any continued employment of the petitioner;
``(B) the interests of justice;
``(C) any relevant evidence; and
``(D) the totality of the circumstances.
``(4) Certified copy of permission.--The Secretary shall
require, as a condition of granting any exception to a
petitioner under this subsection, that the petitioner agree
to maintain on his or her person a certified copy of the
Secretary's permission to possess and use body armor,
including any conditions or limitations.
``(5) Rule of construction.--Nothing in this subsection may
be construed to--
``(A) require the Secretary to grant relief to any
particular petitioner; or
``(B) imply that any relief granted by the Secretary under
this subsection relieves any other person from any liability
that may otherwise be imposed.
``(c) Immunity From Liability.--
``(1) In general.--An officer or employee of a law
enforcement agency who enforces the prohibition specified in
subsection (a) against a person who has been granted relief
pursuant to subsection (b), shall be immune from any
liability for false arrest arising from the enforcement of
this section unless the person has in his or her possession a
certified copy of the permission granting the person relief
from the prohibition, as required by subsection (b)(4).
``(2) Rule of construction.--The immunity from liability
described in paragraph (1) shall not relieve any person or
entity from any other liability that may otherwise be
imposed.''.
(2) Clerical amendment.--The analysis for chapter 44 of
title 18, United States Code, is amended by adding at the end
the following:
``931. Prohibition on purchase, ownership, or possession of body armor
by violent felons.''.
(c) Penalties.--Section 924(a) of title 18, United States
Code, is amended by adding at the end the following:
``(7) Whoever knowingly violates section 931 shall be fined
under this title, imprisoned not more than 3 years, or
both.''.
SEC. 6. DONATION OF FEDERAL SURPLUS BODY ARMOR TO STATE AND
LOCAL LAW ENFORCEMENT AGENCIES.
(a) Definitions.--In this section, the terms ``Federal
agency'' and ``surplus property'' have the meanings given
such terms under section 3 of the Federal Property and
Administrative Services Act of 1949 (40 U.S.C. 472).
[[Page S3646]]
(b) Donation of Body Armor.--Notwithstanding section 203 of
the Federal Property and Administrative Services Act of 1949
(40 U.S.C. 484), the head of a Federal agency may donate body
armor directly to any State or local law enforcement agency,
if such body armor is--
(1) in serviceable condition; and
(2) surplus property.
(c) Notice to Administrator.--The head of a Federal agency
who donates body armor under this section shall submit to the
Administrator of General Services a written notice
identifying the amount of body armor donated and each State
or local law enforcement agency that received the body armor.
(d) Donation by Certain Officers.--
(1) Department of justice.--In the administration of this
section with respect to the Department of Justice, in
addition to any other officer of the Department of Justice
designated by the Attorney General, the following officers
may act as the head of a Federal agency:
(A) The Administrator of the Drug Enforcement
Administration.
(B) The Director of the Federal Bureau of Investigation.
(C) The Commissioner of the Immigration and Naturalization
Service.
(D) The Director of the United States Marshals Service.
(2) Department of the treasury.--In the administration of
this section with respect to the Department of the Treasury,
in addition to any other officer of the Department of the
Treasury designated by the Secretary of the Treasury, the
following officers may act as the head of a Federal agency:
(A) The Director of the Bureau of Alcohol, Tobacco, and
Firearms.
(B) The Commissioner of Customs.
(C) The Director of the United States Secret Service.
____
By Mr. ROCKEFELLER (for himself, Mr. Mack, Mr. Frist, Mrs.
Feinstein, Ms. Mikulski, Mr. Sarbanes, Mr. Conrad, Mr. Johnson,
Mr. Wellstone, Mr. Smith of Oregon, Ms. Collins, Mr. Jeffords,
Mr. Moynihan, Mr. Bingaman, Mr. Inouye, Mr. Craig, Mr. Graham,
Mr. Kerry, Mr. Harkin, and Mr. Leahy):
S. 784 A bill to establish a demonstration project to study and
provide coverage of routine patient care costs for medicare
beneficiaries with cancer who are enrolled in an approved clinical
trial program; to the Committee on Finance.
Medicare Cancer Clinical Trials Coverage Act
Mr. ROCKEFELLER. Mr. President, I am pleased to be introducing the
``Medicare Cancer Clinical Trials Coverage Act of 1999'' with my
colleague from Florida, Senator Mack. This legislation would establish
a demonstration project to assure Medicare beneficiaries with cancer
that Medicare will cover their routine patient costs when part of a
clinical trial.
I would like to thank Senator Mack for his leadership and dedication
on this issue. It has been a pleasure to work with Senator Mack, a
tireless champion for cancer patients throughout his years of service
in the Senate.
With 1,500 deaths due to cancer each day and 1.3 million new cancer
diagnoses this year, there is a clear and urgent need for this
legislation. Our senior population is especially at risk--Medicare
beneficiaries make up half of all cancer diagnoses and 60% of all
cancer deaths. Yet, Medicare's policy toward covering quality cancer
care is ambiguous and its enforcement practices are unpredictable.
Our legislation represents a significant step forward in the fight to
prevent, detect and treat cancer quickly and effectively. It is based
on a very simple premise: given the disproportionate impact that cancer
has on older Americans, Medicare should be responsible for the routine
patient care costs associated with approved clinical trials.
Cancer clinical trials often represent a cancer patient's best hope
for survival, especially when their cancer fails to respond to
traditional therapies. Yet, under current law, Medicare beneficiaries
can be denied coverage for the routine patient care costs associated
with clinical trials. However, if the same care is provided outside of
a clinical trial setting, it is covered by Medicare.
It is a tragedy that the costs of participating in a clinical trial
are discouraging patients from using what might be their best weapon in
a battle with cancer. Medicare beneficiaries who are cancer patients
are left with only two choices: pay the costs out of their own pocket,
or forgo treatment all together. It is unfair, and unconscionable, that
we force cancer patient to make this decision.
There are other compelling reasons to cover these costs. By paying
for these routine costs, we provide incentives for researchers to
include more Medicare beneficiaries in cancer clinical trials.
Researchers know that patients who are at different stages physically,
mentally, and emotionally will react very differently to treatments--
even if they are fighting the same cancer. But what they don't know is
how age and health interact with the safety and effectiveness of new
drugs and treatments. Our bill helps them find the answers to those
critical questions.
Our bill saves money in the long-run by ensuring the Medicare program
pays for treatments that work. Clinical studies can determine which
interventions work the best, and when they are the most effective.
Finally, in establishing a demonstration project, this bill will also
provide valuable information about the costs and benefits of providing
coverage for clinical trials for other life-threatening diseases. We
started with cancer first because cancer is a major affliction of
Medicare beneficiaries. In addition there is a well-established
national clinical cancer trial system to deliver this patient care.
Mr. President, our legislation does not create a new benefit. It
merely ensures that patients enrolled in clinical studies receive
Medicare coverage for the same type of routine patient care costs, such
as hospital and physician fees, that would be covered outside of a
trial setting. We are not asking Medicare to pay for the cost of
research. These expenses will still be covered by trial sponsors,
including pharmaceutical companies.
The ``Medicare Cancer Clinical Trials Coverage Act'' is a modest
proposal, but it has the potential to become a new weapon in the fight
against cancer. But we must act now. We have fought for this proposal
in previous sessions of Congress, and I believe the momentum is
building to get the legislation passed this year. I look forward to
working with Senator Mack and others to take an important step forward
for cancer patients.
Mr. President, I ask unanimous consent that the bill be printed in
the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 784
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medicare Cancer Clinical
Trial Coverage Act of 1999''.
SEC. 2. MEDICARE CANCER PATIENT DEMONSTRATION PROJECT.
(a) Establishment.--Not later than January 1, 2000, the
Secretary of Health and Human Services (in this Act referred
to as the ``Secretary'') shall establish a demonstration
project that provides for payment under the medicare program
under title XVIII of the Social Security Act (42 U.S.C. 1395
et seq.) of routine patient care costs--
(1) that are provided to an individual diagnosed with
cancer and enrolled in the medicare program under such title
as part of the individual's participation in an approved
clinical trial program; and
(2) that are not otherwise eligible for payment under such
title for individuals who are entitled to benefits under such
title.
(b) Application.--The beneficiary cost-sharing provisions
under the medicare program, such as deductibles, coinsurance,
and copayment amounts, shall apply to any individual
participating in a demonstration project conducted under this
Act.
(c) Approved Clinical Trial Program.--For purposes of this
Act, the term ``approved clinical trial program'' means a
clinical trial program that is approved by--
(1) the National Institutes of Health;
(2) a National Institutes of Health cooperative group or a
National Institutes of Health center;
(3) the Food and Drug Administration (in the form of an
investigational new drug or device exemption);
(4) the Department of Veterans Affairs;
(5) the Department of Defense; or
(6) a qualified nongovernmental research entity identified
in the guidelines issued by the National Institutes of Health
for center support grants.
(d) Routine Patient Care Costs.--
(1) In general.--For purposes of this Act, ``routine
patient care costs'' shall include the costs associated with
the provision of items and services that--
(A) would otherwise be covered under the medicare program
if such items and services were not provided in connection
with an approved clinical trial program; and
(B) are furnished according to the design of an approved
clinical trial program.
(2) Exclusion.--For purposes of this Act, ``routine patient
care costs'' shall not include the costs associated with the
provision of--
[[Page S3647]]
(A) an investigational drug or device, unless the Secretary
has authorized the manufacturer of such drug or device to
charge for such drug or device; or
(B) any item or service supplied without charge by the
sponsor of the approved clinical trial program.
SEC. 3. STUDY, REPORT, AND TERMINATION.
(a) Study.--The Secretary shall study the impact on the
medicare program under title XVIII of the Social Security Act
of covering routine patient care costs for individuals with a
diagnosis of cancer and other diagnoses, who are entitled to
benefits under such title and who are enrolled in an approved
clinical trial program.
(b) Report to Congress.--Not later than January 1, 2004,
the Secretary shall submit a report to Congress that contains
a statement regarding--
(1) any incremental cost to the medicare program under
title XVIII of the Social Security Act resulting from the
provisions of this Act; and
(2) a projection of expenditures under the medicare program
if coverage of routine patient care costs in an approved
clinical trial program were extended to individuals entitled
to benefits under the medicare program who have a diagnosis
other than cancer.
(c) Termination.--The provisions of this Act shall not
apply after December 31, 2004.
Mr. FRIST. Mr. President, I am pleased to join today with my
colleagues, Senators Rockefeller and Mack to introduce legislation that
will provide Medicare patients who are battling cancer with coverage of
their health care costs when they participate in approved clinical
trials. For patients suffering from life-threatening illness such as
cancer, the opportunity to participate in clinical trials often offers
them their best hope for access to the latest and most advanced
treatment modalities.
Medicare currently does not pay the costs of patient care associated
with clinical trials because they are experimental therapies. Our bill
proposes that we begin a demonstration project through Medicare--the
nation's largest third party payor--to provide coverage of routine
patient costs associated with approved cancer clinical trials. It is a
demonstration program because there has been much debate over the costs
associated with clinical trials and a clear need exists to gather
better cost data. Unfortunately, dispute still exists over how to
distinguish between routine patient costs and those associated with the
trial. The full impact on health care costs is not yet known.
Thus our bill requires the Secretary of Health and Human Services to
conduct this demonstration project to study the feasibility of covering
patient costs for beneficiaries diagnosed with cancer and enrolled in
clinical trials approved by the National Institutes of Health, the Food
and Drug Administration, Department of Defense, and the Department of
Veteran Affairs. The Secretary is required to report to Congress
concerning the incremental costs attributed to the trial and the
advisability of covering other diseases. Once Congress has these data
in hand, we will be able to make the determination to enact legislation
to make the coverage of routine care costs in clinical trials a
permanent part of the Medicare program.
We have spent many years debating this bill and urging the
Administration to begin this demonstration project. As a research
investigator involved in clinical trials, as a thoracic cancer surgeon,
and as co-director of the Thoracic Oncology Clinic at Vanderbilt
University Medical Center, I know first-hand the critical importance of
clinical trials in determining the very best therapies in our battles
against cancer. Only through participation in clinical trials can we
advance quality care for patients with cancer.
Since I have come to the United States Senate, I have urged my
colleagues to make federal funding for both basic and clinical research
a national priority by doubling the budget of the National Institutes
of Health over the next five years. Last year we witnessed an historic
increase of $2 billion that brought us closer to this goal. But we
cannot stop there. If we do not capitalize on this investment by
further supporting our clinical research infrastructure and the conduct
of clinical trials, we will not reap the full benefits of our
investment.
Clinical trials are scientific studies that allow us to investigate
how new medicines and clinical treatments work in patients. Patients
should recognize that clinical trials are by their nature
investigational and therefore are not a magic bullet or without risk.
Patients should be fully informed of the potential benefits and,
equally important, the potential risks of participating in a clinical
investigation. With this in mind, patients should be given the
opportunity to participate in clinical investigations which may allow
them to receive cutting-edge treatments that may improve their chances
of survival. Clinical investigations advance our scientific knowledge
and help bring about medical innovations to find better treatments for
patients.
We must continue to foster both public and private efforts to support
clinical trials. I believe our foremost federal responsibility is to
address access to clinical trials in our publicly-financed programs
such as Medicare. We must first determine the criteria the Medicare
program will use to evaluate which clinical trials are eligible for
coverage and which costs will be covered. This has not been an easy
task.
We have also been reviewing the proposal to require private health
plans and insurers to cover routine costs associated with standard
patient care while participating in a clinical trial. The Senate Health
and Education Committee, on which I serve, had an informative debate
last month on the issue of clinical trials coverage during our
consideration of S. 326, ``The Patients' Bill of Rights.'' The
amendment we were considering went beyond the Medicare demonstration
project by requiring private sector health plans to cover costs
associated with clinical trials for patients with any life-threatening
or serious illness. Several members of our committee, including myself,
expressed concern that before mandating such broad requirements on the
private sector, we should first determine what costs would be incurred.
In a time of rising health care costs, we must be cautious in our
efforts to provide patient protections that do not drive up costs
further or we will not be serving patients well.
Therefore, I offered an amendment to have a comprehensive study
conducted by the Institute of Medicine to assess patient access to
clinical trials and the coverage of routine patient care costs by
private health plans and insurers. Our efforts should not end there.
That is just the beginning. I am encouraged by recent collaborative
efforts between the National Institutes of Health and the American
Association of Health Plans to increase participation of patients in
clinical trials and to encourage health plans to cover routine patient
costs. We need to monitor this effort closely and explore other ways to
promote public-private collaboration and to gather the necessary data
that will reveal the true impact on health care costs. I will continue
to pursue this effort in a systematic way with my colleagues.
We must not wait any longer to launch the Medicare demonstration
project that our bill today addresses. The longer we wait, the longer
patients are denied access to potentially life-saving therapies and the
longer it will take for new therapies to become standard therapy. And
we must continue to address the issue of clinical trial coverage by the
private sector to bring about patients' access to new clinical
therapies while being mindful of the costs we are imposing. Patients
and their families deserve that we give thoughtful consideration to
both of these legislative proposals this year.
______
By Ms. MIKULSKI (for herself, Ms. Snowe, Mr. Sarbanes, Ms.
Collins, and Mr. Lott):
S. 786. A bill to amend title II of the Social Security Act to
provide that a monthly insurance benefit thereunder shall be paid for
the month in which the recipient dies, subject to a reduction of 50
percent if the recipient dies during the first 15 days of such month,
and for other purposes; to the Committee on Finance.
social security family protection act
Ms. MIKULSKI. Mr. President, today, I rise to talk about an issue
that is very important to me, very important to my constituents in
Maryland and very important to the people of the United States of
America.
For the third Congress in a row, I am joining in a bipartisan effort
with my friend and colleague, Senator Olympia Snowe, to end an unfair
policy of the Social Security System.
Senator Snowe and I are introducing the Social Security Family
Protection Act. This bill addresses retirement security and family
security. We want
[[Page S3648]]
the middle class of this Nation to know that we are going to give help
to those who practice self-help.
What is it I am talking about? We have found that Social Security
does not pay benefits for the last month of life. If a Social Security
retiree dies on the 18th of the month or even on the 30th of the month,
the surviving spouse or family members must send back the Social
Security check for that month.
I think that is a harsh and heartless rule. That individual worked
for Social Security benefits, earned those benefits, and paid into the
Social Security trust fund. The system should allow the surviving
spouse or the estate of the family to use that Social Security check
for the last month of life.
This legislation has an urgency, Mr. President. When a loved one
dies, there are expenses that the family must take care of. People have
called my office in tears. Very often it is a son or a daughter that is
grieving the death of a parent. They are clearing up the paperwork for
their mom or dad, and there is the Social Security check. And they say,
``Senator, the check says for the month of May. Mom died on May 28. Why
do we have to send the Social Security check back? We have bills to
pay. We have utility coverage that we need to wrap up, mom's rent, or
her mortgage, or health expenses. Why is Social Security telling me,
`Send the check back or we're going to come and get you'?''
With all the problems in our country today, we ought to be going
after drug dealers and tax dodgers, not honest people who have paid
into Social Security, and not the surviving spouse or the family who
have been left with the bills for the last month of their loved one's
life. They are absolutely right when they call me and say that Social
Security was supposed to be there for them.
That is what our bill is going to do. That is why Senator Snowe and I
are introducing the Family Social Security Protection Act. When we talk
about retirement security, the most important part of that is income
security. And the safety net for most Americans is Social Security.
We know that as Senators we have to make sure that Social Security
remains solvent, and we are working to do that. We also don't want to
create an undue administrative burden at the Social Security
Administration--a burden that might affect today's retirees. But it is
absolutely crucial that we provide a Social Security check for the last
month of life.
How do we propose to do that? We have a very simple, straightforward
way of dealing with this problem. Our legislation says that if you die
before the 15th of the month, you will get a check for half the month.
If you die after the 15th of the month, your surviving spouse or the
family estate would get a check for the full month.
We think this bill is fundamentally fair. Senator Snowe and I are
old-fashioned in our belief in family values. We believe you honor your
father and your mother. We believe that it is not only a good religious
and moral principle, but it is good public policy as well.
The way to honor your father and mother is to have a strong Social
Security System and to make sure the system is fair in every way. That
means fair for the retiree and fair for the spouse and family. That is
why we support making sure that the surviving spouse or family can keep
the Social Security check for the last month of life.
Mr. President, we urge our colleagues to join us in this effort and
support the Social Security Family Protection Act.
______
By Mr. BURNS (for himself, Mr. Enzi and Mr. Craig):
S. 788. A bill to amend the Federal Meat Inspection Act to provide
that a quality grade label issued by the Secretary of Agriculture may
not be used for imported meat and meat food products; to the Committee
on Agriculture, Nutrition, and Forestry.
usda grade rescission act of 1999
Mr. BURNS. Mr. President, I rise today to sponsor a bill on an issue
of great importance to my state and the agricultural industry. The
issue is that of rescinding the USDA Grade Stamp on foreign meat
products coming into America from other countries and unfairly
receiving the USDA Grade Stamp.
This language offered today will insure that all meat products
imported from a foreign country will not be graded USDA. For years
other countries have used the USDA Grade Stamp to their advantage.
Particularly, Canada and Mexico ship livestock into the United States
and reap the benefits of the premium given for USDA Prime, USDA Choice
or USDA Select.
USDA Prime and USDA Choice grades are given a premium price.
Competition from foreign countries effectively prevents that same
number of American livestock producers from receiving a premium. USDA
should mean just that the meat was raised and slaughtered in the United
States, and given the stamp by the United States Department of
Agriculture.
Currently, boxed beef is not eligible to receive the USDA Grade
Stamp. However, agricultural producers across the border ship livestock
to the United States and feed them for a short period of time in order
to bypass that restriction. The animals are then slaughtered here as
United States product. This is not only unfair, it is a betrayal of
trust. It is one that we will no longer tolerate. My bill provides for
a 90 day feeding period to prevent this from happening, yet maintain
the profits light-weight cattle from foreign countries bring to
American feeders.
The huge influx of imports from both Canada and Mexico that American
agricultural producers are currently faced with has provided an added
hardship to the agricultural economy. Additionally, when consumers see
the USDA Grade Stamp on a meat product they are under the assumption
they are buying U.S. made product. In fact, this is usually not the
case. Even though carcasses are required to have a ``foreign origin
marking'', it is trimmed off for marketing purposes.
Essentially, this bill will protect both the American producer and
the American consumer. The USDA Grade Stamp on foreign product is a
detriment to both. It is a detriment to the producer because foreign
countries get the benefit of the grade stamp, without having to pay for
it. America's producers need the assurance that the USDA label really
means just that--produced in the U.S. It is a detriment to the consumer
because they deserve to know that they are buying American. I've said
it before and I'll say it again. U.S. consumers deserve to know that
they are buying absolutely the safest food supply in the world, which
is grown by American farmers and ranchers. With this in mind we then
should be informing the American consumer that they really are
purchasing American product.
I am proud and very pleased to serve as sponsor of this bill and I
look forward to moving it through the legislative process so we may
give our consumers and producers the information and advantage of
knowing their meat was produced in the USA.
______
By Mr. McCAIN:
S. 789. A bill to amend title 10, United States Code, to authorize
payment of special compensation to certain severely disabled uniformed
services retirees; to the Committee on Armed Services.
Legislation to Authorize Special Pay For Severely Disabled Retired
Veterans
Mr. McCAIN. Mr. President, I am introducing legislation today to
authorize special compensation for severely disabled military retirees
who suffer under an existing law regarding ``concurrent receipt.'' As
many of my colleagues know, current law requires military retirees who
are rated as disabled to offset their military retired pay by the
amount they receive in veterans' disability compensation. This
requirement is discriminatory and wrong.
Today, America's disabled military retirees--those individuals who
dedicated their careers to military service, and who suffered disabling
injuries in the course of that service--cannot receive concurrently
their military retirement pay, which they have earned through at least
20 years of service in the Armed Forces, and their veterans' disability
compensation, which they are owed due to pain and suffering incurred
from military service. In other words, the law penalizes the very men
and women who have sacrificed their physical or psychological well-
being in uniformed service to their country.
The legislation I am introducing today does not provide for full
payment
[[Page S3649]]
to eligible veterans of both the disability compensation and the
retired pay they have earned. I regret that such a proposal, which I
support in principle, would be far more expensive than many of my
colleagues could accept. I learned that lesson the hard way in the
course of sponsoring more ambitious concurrent receipt proposals in
previous Congresses.
My current legislation would instead authorize special compensation
for the most severely disabled retired veterans--those who have served
for at least 20 years, and who have disability ratings of between 70
and 100 percent. More specifically, it would authorize monthly payments
of $300 for totally disabled retired veterans; $200 for retirees rated
as 90 percent disabled; and $100 for retirees with disability ratings
of 70-80 percent.
These men and women suffer from disabilities that have kept them from
pursuing second careers. If we cannot muster the votes to provide them
with their disability pay and retired pay concurrently, the least we
can do is authorize a modest special compensation package to
demonstrate that we have not forgotten their sacrifices. At $42 million
per year, this legislation comes nowhere near approaching the price tag
of more expansive concurrent receipt proposals. Moreover, it involves
only discretionary, not mandatory, spending.
In short, it is affordable. And it is the right thing to do. But
don't take my word for it. The Military Coalition, an organization of
30 prominent veterans' and retirees' advocacy groups, supports my
legislation, as do many other veterans' service organizations,
including the American Legion and Disabled American Veterans. These
highly respected organizations recognize, as I do, that severely
disabled military retirees deserve, at a minimum, special compensation
for the honorable service they have rendered the United States.
My interest in actively resolving the concurrent receipt issue dates
to 1993, when I included a provision in the Fiscal Year 1994 Defense
Authorization bill directing the Department of Defense (DoD) to submit
a concurrent receipt legislative proposal to the House and Senate Armed
Services Committees. When that deadline was not met, I took the
opportunity at a Senate Armed Services Personnel Subcommittee hearing
to ask the then-Deputy Assistant Secretary of Defense for Military
Manpower and Personnel Policy about the status of the concurrent
receipt report. Although he replied that Congress would receive it in
June 1993, the report arrived seven months late. Clearly, the
concurrent receipt issue was not then a DoD priority, nor is it today.
I also worked with the Armed Services Committee to include
legislation in the FY 1994 Defense Authorization bill to exempt
military retirees who are rated as 100 percent disabled from the
requirement to offset their military pay by the amount they receive in
veterans' disability pay. Although I had assumed that no one could deny
a military retiree with 100 percent disability from receiving both his
retirement and his disability pay, my legislation was never enacted
into law.
Undeterred, in 1994 I introduced legislation, which was included in
the Senate version of the Defense Appropriations bill for FY 1995,
directing the Secretary of Defense to authorize the concurrent payment
of military retired pay and veterans' disability compensation. Although
my amendment had 16 cosponsors and received bipartisan support in the
Senate, it was regrettably reduced to just a study by the House of
Representatives during conference negotiations on the bill.
This amendment was heralded by more than 30 separate veterans'
associations as a means of redressing the unjust offset of retirement
pay with disability compensation. It provided for concurrent payment of
retirement and disability compensation if the following criteria were
met:
(1) the veteran had completed 20 years of military service;
(2) the disability was incurred or aggravated in the performance of
duty in military service; and
(3) the disability was rated as 100 percent at the time of retirement
or within four years of the veteran's retirement date.
I introduced these concurrent receipt amendments because the existing
requirement that military retired pay be offset dollar-for-dollar by
veterans' disability compensation is inequitable. I firmly believe that
non-disability military retired pay is post-service compensation for
services rendered in the United States military. Veterans' disability
pay, on the other hand, is compensation for a physical or mental
disability incurred from the performance of such service. In my view,
the two pays are for very different purposes: one for service rendered
and the other for physical or mental ``pain and suffering.'' This is an
important distinction evident to any military retiree currently forced
to offset his retirement pay with disability compensation.
Concurrent receipt is, at its core, a fairness issue, and present law
simply discriminates against career military people. Retired veterans
are the only group of federal retirees who are required to waive their
retirement pay in order to receive VA disability. This inequity needs
to be corrected.
In the 105th Congress, I was proud to have co-sponsored S. 657, a
bill sponsored by Senator Daschle that would eliminate the offset on a
graduated scale based on the inverse of the retiree's disability
rating. For instance, a veteran who is 90 percent disabled would have
to offset his retirement pay by an amount equal to 10 percent of his
total VA disability. This compromise would establish the right of a
disabled military retiree to receive at least a portion of his earned
military retirement. Unfortunately, the full Congress did not act on
this legislation before adjourning in October 1998.
In the past, Congressional attempts to rectify discrimination against
disabled career service members have been accompanied by staggering
cost estimates, dooming to failure again and again proposed remedies to
the concurrent receipt dilemma. The concurrent receipt legislation I
supported in the 105th Congress reflected an attempt to ease the offset
burden on retired disabled service members while avoiding significant
deficit expansion. My current legislation in the 106th Congress is even
more conscious of the costs associated with properly compensating
disabled military retirees.
Unfortunately, cost concerns must remain a consideration as we seek
to promote a system of concurrent receipt that is both equitable and
consistent with our balanced budget objective. While I would prefer to
implement a system aimed first and foremost at severely disabled
veterans, as my earlier legislation proposed, I believe S. 657
represented a step in the right direction and was worthy of Congress'
support. Similarly, I believe the special compensation authorized by my
current legislation makes progress by targeting the most severely
disabled veterans, even if it does not revoke the discriminatory
concurrent receipt restrictions that remain in place today.
I continue to hope that the Pentagon, once it finally understands our
message that it cannot continue to unfairly penalize disabled military
retirees, will provide Congress with a fair and equitable plan to
properly compensate retired service members with disabilities. It is
hard to disagree with the simple logic that disabled veterans both need
and deserve our full support after the untold sacrifices they made in
defense of this country.
I look forward to the day when our disabled retirees are no longer
unduly penalized by existing limitations on concurrent receipt of the
benefits they deserve. In the meantime, I urge my colleagues to support
this legislation.
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. 789
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SPECIAL COMPENSATION FOR SEVERELY DISABLED
UNIFORMED SERVICES RETIREES.
(a) Authority.--(1) Chapter 71 of title 10, United States
Code, is amended by adding at the end the following new
section:
``Sec. 1413. Special compensation for certain severely
disabled uniformed services retirees
``(a) Authority.--The Secretary concerned shall, subject to
the availability of appropriations for such purpose, pay to
each eligible disabled uniformed services retiree a monthly
amount determined under subsection (b).
[[Page S3650]]
``(b) Amount.--The amount to be paid to an eligible
disabled uniformed services retiree in accordance with
subsection (a) is the following:
``(1) For any month for which the retiree has a qualifying
service-connected disability rated as total, $300.
``(2) For any month for which the retiree has a qualifying
service-connected disability rated as 90 percent, $200.
``(3) For any month for which the retiree has a qualifying
service-connected disability rated as 80 percent or 70
percent, $100.
``(c) Eligible Members.--An eligible disabled uniformed
services retiree referred to in subsection (a) is a member of
the uniformed services in a retired status (other than a
member who is retired under chapter 61 of this title) who--
``(1) completed at least 20 years of service in the
uniformed services that are creditable for purposes of
computing the amount of retired pay to which the member is
entitled; and
``(2) has a qualifying service-connected disability.
``(d) Qualifying Service-Connected Disability Defined.--In
this section, the term `qualifying service-connected
disability' means a service-connected disability that--
``(1) was incurred or aggravated in the performance of duty
as a member of a uniformed service, as determined by the
Secretary concerned; and
``(2) is rated as not less than 70 percent disabling--
``(A) by the Secretary concerned as of the date on which
the member is retired from the uniformed services; or
``(B) by the Secretary of Veterans Affairs within four
years following the date on which the member is retired from
the uniformed services.
``(e) Status of Payments.--Payments under this section are
not retired pay.
``(f) Source of Funds.--Payments under this section for any
fiscal year shall be paid out of funds appropriated for pay
and allowances payable by the Secretary concerned for that
fiscal year.
``(g) Other Definitions.--In this section:
``(1) The term `service-connected' has the meaning give
that term in section 101 of title 38.
``(2) The term `disability rated as total' means--
``(A) a disability that is rated as total under the
standard schedule of rating disabilities in use by the
Department of Veterans Affairs; or
``(B) a disability for which the scheduled rating is less
than total but for which a rating of total is assigned by
reason of inability of the disabled person concerned to
secure or follow a substantially gainful occupation as a
result of service-connected disabilities.
``(3) The term `retired pay' includes retainer pay,
emergency officers' retirement pay, and naval pension.''.
(2) The table of sections at the beginning of such chapter
is amended by adding at the end the following new item:
``1413. Special compensation for certain severely disabled uniformed
services retirees.''.
(b) Effective Date.--Section 1413 of title 10, United
States Code, as added by subsection (a), shall take effect on
October 1, 1999, and shall apply to months that begin on or
after that date. No benefit may be paid to any person by
reason of that section for any period before that date.
______
By Mr. LAUTENBERG:
S. 790. A bill to amend the Federal Food, Drug, and Cosmetic Act to
require manufacturers of bottled water to submit annual reports, and
for other purposes; to the Committee on Environment and Public Works.
the bottled water safety and right-to-know act of 1999
Mr. LAUTENBERG. Mr. President, I am introducing today the Bottled
Water Safety and Right-to-Know Act of 1999. This legislation is
designed to ensure that bottled water safety standards protect public
health, and to give consumers the right to know about contaminants in
their bottled water.
Mr. President, I have been interested in bottled water for several
years. Bottled water consumption has doubled in the U.S. since 1987,
largely due to the public perception that bottled water is cleaner and
safer than tap water. This is especially true in my state, where we
hear so often about contamination of tap water. Unfortunately, bottled
water today does not have to meet all the same safety standards met by
tap water. Nor do consumers have the right to know about the
contaminats found in bottled water. Let me discuss each of these issues
in more detail.
There is an important disparity between contaminant standards for
bottled water and those for tap water. Bottled water is regulated as a
food by the Food and Drug Administration (FDA) under the Food, Drug,
and Cosmetic Act, while tap water is regulated by the Environmental
Protection Agency (EPA). Unfortunately, several contaminants are
regulated less stringently in bottled water by the FDA than in tap
water by the EPA. In particular, the FDA has no standard for phthalate,
a probable human carcinogen which leaches out of some plastic bottles,
no ban on fecal coliform of E. Coli, and weaker standards for several
other contaminants. In addition, the infrastructure guaranteeing the
safety of bottled water is far weaker than the regulatory programs the
EPA and its state and local partners have established for tap water.
There is, in addition, a disparity in the transparency of information
about the two types of water. Public water systems have long been
required to monitor contaminant levels and allow no more than a maximum
amount of contamination in their water. Facing only these regulatory
requirements, however, water companies had little incentive to provide
more than the minimum-required level of drinking water protection. The
Safe Drinking Water Act Amendments of 1996 changed that by adding
consumer Right-to-Know requirements to the existing regulatory
programs. The purpose of the Right to Know requirements is to increase
public understanding of drinking water threats, foster public demand
for prevention of those threats, and thereby lead water companies and
state and local agencies to go beyond the minimum requirements in
preventing the threats.
Unfortunately, no equivalent Right to Know exists for bottled water.
Customers have no way to know whether the bottled product--hundreds of
times more expensive than what comes out of the tap--is the safer,
cleaner product. In other words, Mr. President, bottled water is the
snake oil of the 1990's--it is sold as a cleaner product purely on the
basis of claims and perception, not facts.
The Bottled Water Safety and Right-to-Know Act of 1999 would correct
these deficiencies, establishing contaminant standards and Right-to-
Know requirements for bottled water at least as stringent as those
placed on tap water.
First, the bill would give the FDA two years to make all standards
for contaminants in bottled water as protective of public health as the
tap water standards established by the EPA, the State of California,
the World Health Organization, and the European Union. If the FDA
failed to implement this requirement, the bill would transfer
regulatory authority over bottled water to the EPA.
Second, the bill would require that bottled water companies list, on
their products' labels, the concentration of any regulated contaminant
found at levels high enough to cause adverse health effects, and of any
other contaminants whose presence in tap water would be disclosed to
the public under federal law. Bottled water without contamination would
require no such contaminant labelling. In addition, labels would name
the source of the water, the type of treatment applied, and whether the
treatment meets the EPA's criteria of full protection of immuno-
compromised individuals from Cryptosporidium and other microbial
pathogens.
Finally, the bill would require bottled water companies to send the
FDA information on the contaminants in the water, the source of the
water, and type of treatment applied. The FDA would then make the
reported information, information on the recent inspection and
enforcement history of the relevant bottled water facilities, and other
background information available to the public through the Internet and
in paper form through a 1-800 number, both of which would be printed on
bottle labels.
Mr. President, bottled water consumers have the right to bottled
water that is as safe as tap water, and they have the right to know
about the contaminants in their bottled water.
I urge my colleagues to co-sponsor this legislation, and ask
unanimous consent that the bill be printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 790
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Bottled Water Safety and
Right to Know Act of 1999''.
[[Page S3651]]
SEC. 2. CONSUMER CONFIDENCE REPORTS.
Section 410 of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 349) is amended--
(1) in subsection (b), by adding at the end the following:
``(5) The Secretary shall--
``(A) not later than 6 months after the date of enactment
of this paragraph identify contaminants for which--
``(i) the Administrator has established a national primary
drinking water regulation under section 1412 of the Safe
Drinking Water Act (42 U.S.C. 300g-1) and the Secretary has
not established a standard of quality regulation for such
contaminant or has established a standard of quality
regulation or monitoring requirement that may be less
protective of public health than the national primary
drinking water regulation; or
``(ii) the Secretary has established a standard of quality
regulation for such contaminant that may be less protective
of public health than the standard for such a contaminant
issued by the World Health Organization, the European Union,
or the State of California; and
``(B) not later than 12 months after that date of
enactment, propose an interim standard of quality regulation,
for each contaminant identified under subparagraph (A), that
contains a standard or monitoring requirement that is at
least as protective of public health as the more protective
of--
``(i) the national primary drinking water regulation
described in subparagraph (A); or
``(ii) a standard issued by the World Health Organization,
European Union, or the State of California; and
``(C) not later than 24 months after that date of
enactment, issue a final regulation of the standard described
in subparagraph (B), for each identified contaminant.
``(6) The Secretary is authorized to award grants to the
States for the enforcement of the regulations described in
paragraph (5).
``(7)(A) Not later than 24 months after the date of
enactment of this paragraph, the Secretary shall publish
final regulations as described in paragraph (5) in the
Federal Register.
``(B) If the Secretary fails to publish the regulations
described in subparagraph (A), then--
``(i) all functions that the Secretary of Health and Human
Services exercised before the effective date of this
subparagraph (including all related functions of any officer
or employee of the Department of Health and Human Services)
relating to inspections and enforcement concerning bottled
water shall be transferred to the Environmental Protection
Agency;
``(ii) all references to the Secretary in paragraph (5),
notwithstanding the references in clause (i) and (ii) of
subparagraph (A), and all references in paragraph (6) and
subsections (c), (d), and (e) shall instead be to the
Administrator;
``(iii) except as otherwise provided in this subparagraph,
the assets, liabilities, grants, contracts, property,
records, and unexpended balances of appropriations,
authorizations, allocations, and other funds employed, used,
held, arising from, available to, or to be made available in
connection with the functions transferred under clause (i),
subject to section 1531 of title 31, United States Code,
shall be transferred to the Environmental Protection Agency,
and unexpended funds transferred pursuant to this
subparagraph shall be used only for the purposes for which
the funds were originally authorized and appropriated;
``(iv) all orders, determinations, rules, regulations,
permits, agreements, grants, contracts, certificates,
licenses, registrations, privileges, and other administrative
actions--
``(I) that have been issued, made, granted, or allowed to
become effective by the President, any Federal agency or
official of a Federal agency, or by a court of competent
jurisdiction, in the performance of functions that are
transferred under this subparagraph; and
``(II) that were in effect before the effective date of
this subparagraph, or were final before the effective date of
this subparagraph and are to become effective on or after the
effective date of this subparagraph;
shall continue in effect according to their terms until
modified, terminated, superseded, set aside, or revoked in
accordance with law by the President, the Administrator or
other authorized official, a court of competent jurisdiction,
or by operation of law;
``(v) this subparagraph shall not affect any proceedings,
including notices of proposed rulemaking, or any application
for any license, permit, certificate, or financial assistance
pending before the Secretary on the effective date of this
subparagraph, with respect to functions transferred by this
subparagraph;
``(vi) such proceedings and applications described in
clause (v) shall be continued and orders shall be issued in
such proceedings and appeals taken from the orders, and
payments shall be made pursuant to the orders, as if this
subparagraph had not been enacted, and orders issued in any
such proceedings shall continue in effect until modified,
terminated, superseded, set aside, or revoked by a duly
authorized official, by a court of competent jurisdiction, or
by operation of law;
``(vii) nothing in this subparagraph shall be construed to
prohibit the discontinuance or modification of any such
proceeding described in clause (v) under the same terms and
conditions and to the same extent that such proceeding could
have been discontinued or modified if this subparagraph had
not been enacted;
``(viii) this subparagraph shall not affect suits commenced
before the effective date of this subparagraph, and in all
such suits, proceedings shall be had, appeals taken, and
judgments rendered in the same manner and with the same
effect as if this subparagraph had not been enacted;
``(ix) no suit, action, or other proceeding commenced by or
against the Secretary, or by or against any individual in the
official capacity of such individual as an officer of the
Secretary, shall abate by reason of the enactment of this
subparagraph;
``(x) any administrative action relating to the preparation
or promulgation of a regulation by the Secretary relating to
a function transferred under this subparagraph may be
continued by the Administrator with the same effect as if
this subparagraph had not been enacted; and
``(xi) a reference in any other Federal law, Executive
order, rule, regulation, or delegation of authority, or any
document of or relating to--
``(I) the Secretary with regard to functions transferred
under this subparagraph, shall be deemed to refer to the
Administrator; and
``(II) the Department of Health and Human Services with
regard to functions transferred under this subparagraph,
shall be deemed to refer to the Environmental Protection
Agency.
``(C) As used in subparagraph (B), the term `Federal
agency' has the meaning given the term `agency' by section
551(1) of title 5, United States Code.''; and
(2) by adding at the end the following:
``(c)(1) Not later than 18 months after the date of
enactment of this subsection, the Secretary shall issue
regulations that require each manufacturer of bottled water
to submit reports and display information as required under
paragraph (2).
``(2) The regulations issued under paragraph (1) shall
require that each manufacturer of bottled water shall--
``(A) not later than 36 months after the date of enactment
of this subsection and annually thereafter, prepare and
submit in electronic form, on a form provided by the
Secretary, an annual report to the Secretary that describes,
at a minimum--
``(i) the source of the water purveyed;
``(ii) the type of treatment to which the water has been
subjected and whether such treatment meets the Secretary's
criteria for full protection of immuno-compromised
individuals from cryptosporidium and other microbial
pathogens;
``(iii) the amount and range of any regulated contaminant
detected in the water during the reporting year, the maximum
contaminant level goal for the contaminant, if any, and
whether the goal was exceeded during the reporting year; and
``(iv) the amount and range of any unregulated contaminant
detected in the water during the reporting year that is
subject to unregulated contaminant monitoring or notification
requirements under sections 1445 or 1414, respectively, of
the Safe Drinking Water Act (42 U.S.C. 300j-4; 300g-3), or
that the Secretary determines may present a threat to public
health; and
``(B) for the second and each subsequent reporting year,
display on the labels of the bottled water--
``(i) if the maximum contaminant level goal or lowest
health advisory level under the Safe Drinking Water Act
(whichever is lower) for a regulated contaminant is exceeded
during the preceding reporting year--
``(I) the amount and range of the regulated contaminant in
the bottled water;
``(II) the maximum contaminant level goal for the
contaminant; and
``(III) a plain definition of `maximum contaminant level
goal' as determined by the Administrator;
``(ii) the amount and range of any unregulated contaminant
detected in the water during the preceding reporting year
that is subject to unregulated contaminant monitoring or
notification requirements under sections 1445 or 1414,
respectively, of the Safe Drinking Water Act (42 U.S.C. 300j-
4; 300g-3) or that the Secretary has determined may present a
threat to public health;
``(iii) the source of the water;
``(iv) the type of treatment, if any, to which the water
has been subjected and whether such treatment meets the
Secretary's criteria for full protection of immuno-
compromised individuals for cryptosporidium and other
mircobial pathogens;
``(v) the address for the Internet website described in
paragraph (3)(A); and
``(vi) the toll-free telephone number described in
paragraph (3)(B).
``(3) Not later than 6 months after the date on which an
annual report referred to in paragraph (2) is submitted to
the Secretary, the Secretary shall make the report available
to the public--
``(A) on an Internet website maintained by the Secretary;
and
``(B) in paper form, in English, Spanish, and in any other
language determined to be appropriate by the Secretary, upon
request made through use of a toll-free telephone number
maintained by the Secretary.
``(4) In addition to submitting an annual report under
paragraph (2), the manufacturer may also submit a supplement
to the Secretary that contains additional information that
the manufacturer determines to be appropriate for public
education. The Secretary may make the supplement available
[[Page S3652]]
to the public in the same manner as the annual report is made
available to the public under paragraph (3).
``(5) In the same manner as the annual report is made
available to the public under paragraph (3), the Secretary
shall make the following information available to the public:
``(A) The definitions of the terms `maximum contaminant
level goal' and `maximum contaminant level'.
``(B) For any regulated contaminant described in paragraph
(2)(A), a statement setting forth--
``(i) the maximum contaminant level goal;
``(ii) the maximum contaminant level; and
``(iii) if a violation of the maximum contaminant level has
occurred during the reporting year, the potential health
concerns associated with such a violation.
``(C) For any unregulated contaminant described in
paragraph (2)(A), a statement describing the health advisory
or explaining the reasons for determination by the Secretary
that the contaminant may present a threat to public health.
``(D) A statement explaining that the presence of
contaminants in bottled drinking water does not necessarily
create a health risk.
``(E) The date of the last Federal and State inspections of
the bottled water facilities relating to the safety of the
water.
``(F) A statement describing any violations discovered at
the facilities during the inspections described in
subparagraph (E) and any enforcement actions that were taken
as a consequence of the violations.
``(G) The date of recall of any bottled water and the
reasons for the recall.
``(d) Every manufacturer of bottled water who is subject to
any requirement of this section shall maintain such records,
make such reports, conduct such monitoring, and provide such
information as the Secretary may reasonably require by
regulation in order to assist the Secretary in establishing
regulations under this section, in determining whether the
manufacturer has acted or is acting in compliance with this
section, in evaluating the health risks of unregulated
contaminants, or in advising the public of such risks.
``(e) Not later than 12 months after the date of enactment
of this subsection, and annually thereafter, the Secretary
shall make available to the public, in the same manner as the
annual report is made available under subsection (c)(3),
information regarding violations of bottled water regulations
relating to inspections, and any enforcement actions taken in
regards to such violations. The Secretary shall establish and
administer a grant program to fund the gathering of such
information.
``(f) In this section:
``(1) The term `bottled water' means all water sold in the
United States that--
``(A) is intended for human consumption;
``(B) is sealed in bottles or other containers; and
``(C) may be still or carbonated, but has no sweeteners or
juices added to the water, except for trace levels of
flavorings.
``(2) The term `contaminant' means any physical, chemical,
biological, or radiological substance or matter in water.
``(3) The term `maximum contaminant level' has the meaning
given the term in section 1401 of the Safe Drinking Water Act
(42 U.S.C. 300f).
``(4) The term `maximum contaminant level goal' means a
goal established by the Administrator under section 1412 of
the Safe Drinking Water Act (42 U.S.C. 300g-1).
``(5) The term `regulated contaminant' means a contaminant
that is regulated under section 1412 of the Safe Drinking
Water Act (42 U.S.C. 300g-1).
``(6) The term `unregulated contaminant' means a
contaminant that is not regulated under section 1412 of the
Safe Drinking Water Act (42 U.S.C. 300g-1).''.
SEC. 3. PROHIBITED ACTS.
Section 301 of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 331) is amended by adding at the end the following:
``(aa) The failure by a manufacturer of bottled water to
submit an annual report or display the required information
on labels of bottled water in accordance with section
410(c).''.
______
By Mr. SHELBY (for himself and Mr. Sessions):
S.J. Res. 18. A joint resolution honoring World War II crewmembers of
the U.S.S. Alabama on the occasion of the 1999 annual reunion of the
U.S.S. Alabama Crewmen's Association; to the Committee on Veterans'
Affairs.
Joint Resolution for the Sailors of the Battleship USS Alabama
Mr. SHELBY. Mr. President, I rise today to honor a number of American
heroes. During World War Two, over 6,300 sailors and Marines were
members of the crew of the Battleship U.S.S. Alabama. The ship and crew
were instrumental in the defeat of both Germany and Japan. The crew was
credited with the downing of 22 enemy aircraft and was awarded numerous
citations and medals including the European-African-Middle Eastern
Medal and the Asiatic-Pacific Campaign Medal with nine battle stars.
This week, the U.S.S. Alabama Crewman's Association is holding its
annual reunion at Battleship Memorial Park in Mobile, Alabama. I ask
the Senate to pass this Joint Resolution which commends and recognizes
the gallant crewmen of the U.S.S. Alabama. To those men I say
congratulations and thank you for a job well done.
Mr. President, I ask unanimous consent that the text of the joint
resolution be printed in the Record.
There being no objection, the joint resolution was ordered to be
printed in the Record, as follows:
S.J. Res. 18
Whereas the members of the crew of the battleship U.S.S.
Alabama (BB-60) during World War II were a courageous group
who braved both Arctic chill and Pacific heat to help defend
our great country against enemy oppression;
Whereas the U.S.S. Alabama crewed by those men was awarded
nine battle stars and shot down 22 enemy aircraft; and
Whereas the U.S.S. Alabama Crewmen's Association is holding
its annual reunion on April 15 to 18, 1999: Now, therefore,
be it
Resolved by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. COMMENDATION AND RECOGNITION OF CREWMEN OF THE
U.S.S. ALABAMA.
The United States honors the 6,300 persons who were members
of the U.S.S. Alabama's crew during World War II, commends
and thanks them for their sacrifice and service in the
defense of the United States, and recognizes those among them
who are assembling April 15 to 18, 1999, as the U.S.S.
Alabama Crewmen's Association on the occasion of the
association's 1999 annual reunion.
____________________