[Congressional Record Volume 145, Number 79 (Monday, June 7, 1999)]
[Senate]
[Page S6471]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




           FEDERAL PRISONER HEALTH CARE COPAYMENT ACT OF 1999

  On May 27, 1999, the Senate passed S. 704, a bill to amend title 18, 
United States Code, to combat the over-utilization of prison health 
care services and control rising prisoner health care costs. The bill 
is as follows:

                                 S. 704

       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 ``Federal Prisoner Health Care 
     Copayment Act of 1999''.

     SEC. 2. HEALTH CARE FEES FOR PRISONERS IN FEDERAL 
                   INSTITUTIONS.

       (a) In General.--Chapter 303 of title 18, United States 
     Code, is amended by adding at the end the following:

     ``Sec. 4048. Fees for health care services for prisoners

       ``(a) Definitions.--In this section--
       ``(1) the term `account' means the trust fund account (or 
     institutional equivalent) of a prisoner;
       ``(2) the term `Director' means the Director of the Bureau 
     of Prisons;
       ``(3) the term `health care provider' means any person who 
     is--
       ``(A) authorized by the Director to provide health care 
     services; and
       ``(B) operating within the scope of such authorization;
       ``(4) the term `health care visit'--
       ``(A) means a visit, as determined by the Director, 
     initiated by a prisoner to an institutional or 
     noninstitutional health care provider; and
       ``(B) does not include a visit initiated by a prisoner--
       ``(i) pursuant to a staff referral; or
       ``(ii) to obtain staff-approved follow-up treatment for a 
     chronic condition; and
       ``(5) the term `prisoner' means--
       ``(A) any individual who is incarcerated in an institution 
     under the jurisdiction of the Bureau of Prisons; or
       ``(B) any other individual, as designated by the Director, 
     who has been charged with or convicted of an offense against 
     the United States.
       ``(b) Fees for Health Care Services.--
       ``(1) In general.--The Director, in accordance with this 
     section and with such regulations as the Director shall 
     promulgate to carry out this section, may assess and collect 
     a fee for health care services provided in connection with 
     each health care visit requested by a prisoner.
       ``(2) Exclusion.--The Director may not assess or collect a 
     fee under this section for preventative health care services, 
     emergency services, prenatal care, diagnosis or treatment of 
     contagious diseases, mental health care, or substance abuse 
     treatment, as determined by the Director.
       ``(c) Persons Subject to Fee.--Each fee assessed under this 
     section shall be collected by the Director from the account 
     of--
       ``(1) the prisoner receiving health care services in 
     connection with a health care visit described in subsection 
     (b)(1); or
       ``(2) in the case of health care services provided in 
     connection with a health care visit described in subsection 
     (b)(1) that results from an injury inflicted on a prisoner by 
     another prisoner, the prisoner who inflicted the injury, as 
     determined by the Director.
       ``(d) Amount of Fee.--Any fee assessed and collected under 
     this section shall be in an amount of not less than $2.
       ``(e) No Consent Required.--Notwithstanding any other 
     provision of law, the consent of a prisoner shall not be 
     required for the collection of a fee from the account of the 
     prisoner under this section.
       ``(f) No Refusal of Treatment for Financial Reasons.--
     Nothing in this section may be construed to permit any 
     refusal of treatment to a prisoner on the basis that--
       ``(1) the account of the prisoner is insolvent; or
       ``(2) the prisoner is otherwise unable to pay a fee 
     assessed under this section.
       ``(g) Use of Amounts.--
       ``(1) Restitution to specific victims.--Amounts collected 
     by the Director under this section from a prisoner subject to 
     an order of restitution issued pursuant to section 3663 or 
     3663A shall be paid to victims in accordance with the order 
     of restitution.
       ``(2) Allocation of other amounts.--Of amounts collected by 
     the Director under this section from prisoners not subject to 
     an order of restitution issued pursuant to section 3663 or 
     3663A--
       ``(A) 75 percent shall be deposited in the Crime Victims 
     Fund established under section 1402 of the Victims of Crime 
     Act of 1984 (42 U.S.C. 10601); and
       ``(B) 25 percent shall be available to the Attorney General 
     for administrative expenses incurred in carrying out this 
     section.
       ``(h) Reports to Congress.--Not later than 1 year after the 
     date of enactment of the Federal Prisoner Copayment Act of 
     1999, and annually thereafter, the Director shall submit to 
     Congress a report, which shall include--
       ``(1) a description of the amounts collected under this 
     section during the preceding 12-month period; and
       ``(2) an analysis of the effects of the implementation of 
     this section, if any, on the nature and extent of heath care 
     visits by prisoners.''.
       (b) Clerical Amendment.--The analysis for chapter 303 of 
     title 18, United States Code, is amended by adding at the end 
     the following:

``4048. Fees for health care services for prisoners.''.

     SEC. 3. HEALTH CARE FEES FOR FEDERAL PRISONERS IN NON-FEDERAL 
                   INSTITUTIONS.

       Section 4013 of title 18, United States Code, is amended by 
     adding at the end the following:
       ``(c) Health Care Fees for Federal Prisoners in Non-Federal 
     Institutions.--
       ``(1) In general.--Notwithstanding amounts paid under 
     subsection (a)(3), a State or local government may assess and 
     collect a reasonable fee from the trust fund account (or 
     institutional equivalent) of a Federal prisoner for health 
     care services, if--
       ``(A) the prisoner is confined in a non-Federal institution 
     pursuant to an agreement between the Federal Government and 
     the State or local government;
       ``(B) the fee--
       ``(i) is authorized under State law; and
       ``(ii) does not exceed the amount collected from State or 
     local prisoners for the same services; and
       ``(C) the services--
       ``(i) are provided within or outside of the institution by 
     a person who is licensed or certified under State law to 
     provide health care services and who is operating within the 
     scope of such license;
       ``(ii) constitute a health care visit within the meaning of 
     section 4048(a)(4) of this title; and
       ``(iii) are not preventative health care services, 
     emergency services, prenatal care, diagnosis or treatment of 
     contagious diseases, mental health care, or substance abuse 
     treatment.
       ``(2) No refusal of treatment for financial reasons.--
     Nothing in this subsection may be construed to permit any 
     refusal of treatment to a prisoner on the basis that--
       ``(A) the account of the prisoner is insolvent; or
       ``(B) the prisoner is otherwise unable to pay a fee 
     assessed under this subsection.''.

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