[Congressional Record Volume 145, Number 124 (Wednesday, September 22, 1999)]
[House]
[Pages H8557-H8558]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                               AMENDMENTS

  Under clause 8 of rule XVIII, proposed amendments were submitted as 
follows:

                               H.R. 2506

                        Offered by Mr. Bilirakis

       Amendment No. 3: Page 3, line 2, strike ``by'' and all that 
     follows through ``research'' on line 3 and insert the 
     following: ``by conducting and supporting--
       `` `(1) research''.
       Page 4, line 3, strike ``synthesizing and disseminating'' 
     and insert ``the synthesis and dissemination of''.
       Page 4, line 7, strike ``advancing'' and insert 
     ``initiatives to advance''.
       Page 4, beginning on line 11, strike ``shall undertake'' 
     and all that follows through ``evaluations'' on line 12 and 
     insert the following: ``shall conduct and support research 
     and evaluations, and support demonstration projects,''.
       Page 4, line 25, strike ``shall support'' and all that 
     follows through ``activities'' on page 5, line 4, and insert 
     the following: ``shall conduct and support research, 
     evaluations, and training, support demonstration projects, 
     research networks, and multi-disciplinary centers, provide 
     technical assistance, and disseminate information on health 
     care and on systems for the delivery of such care, including 
     activities''.
       Page 6, line 5, strike ``made available under section 487'' 
     and insert ``made available under section 487(d)(3) for the 
     Agency''.
       Page 7, beginning on line 21, strike ``that it uses''.
       Page 7, line 23, strike ``that it uses''.
       Page 7, line 24, strike ``behind health care practice'' and 
     insert ``underlying health care practice''.
       Page 8, beginning on line 15, strike ``Health Care 
     Improvement Research Centers'' and insert ``health care 
     improvement research centers''.
       Page 8, line 20, strike ``Provider-based Research 
     Networks'' and insert ``provider-based research networks''.
       Page 8, line 23, insert ``evaluate and'' before ``promote 
     quality improvement''.
       Page 13, beginning on line 7, strike ``In carrying out 
     902(a), the Director'' and insert ``The Director''.
       Page 14, beginning on line 5, strike ``, the needs'' and 
     all that follows through ``and monitor'' on line 8 and insert 
     the following: ``, including the health care needs of 
     populations identified in section 901(c), provide data to 
     study the relationships between health care quality, 
     outcomes, access, use, and cost, measure changes over time, 
     and monitor''.
       Page 15, beginning on line 10, strike ``shall support 
     research, evaluations and initiatives to advance'' and insert 
     ``shall conduct and support research, evaluations, and 
     initiatives to advance''.
       Page 18, beginning on line 15, strike ``clinical practice 
     and health care technologies'' and insert ``health care 
     practices and technologies''.
       Page 18, beginning on line 21, strike ``health care 
     practices and health care technologies'' and insert ``health 
     care practices and technologies''.
       Page 19, line 1, strike ``promoting education, training, 
     and providing'' and insert ``promoting education and training 
     and providing''.
       Page 19, beginning on line 2, strike ``health care practice 
     and health care technology assessment'' and insert ``health 
     care practice and technology assessment''.
       Page 20, line 4, insert ``health care'' before 
     ``technologies''.
       Page 25, line 5, insert ``National'' before ``Advisory 
     Council''.
       Page 29, beginning on line 4, strike ``the maximum rate of 
     basic pay payable for GS-18 of the General Schedule'' and 
     insert the following: ``the daily equivalent of the annual 
     rate of basic pay prescribed for level IV of the Executive 
     Schedule under section 5315 of title 5, United States Code, 
     for each day during which such member is engaged in the 
     performance of the duties of the Advisory Council''.
       Page 43, line 2, insert ``National'' before ``Advisory 
     Council''.

                               H.R. 2506

                   Offered by: Mr. Davis of Illinois

       Amendment No. 4: Page 6, line 10, insert before the period 
     the following: ``, and with respect to the priority 
     population involved, shall in addition take into 
     consideration the extent to which the individuals who receive 
     the training will maintain a continuing commitment to health 
     services research regarding such population (taking into 
     account demographic, socioeconomic, and other appropriate 
     factors)''.

                               H.R. 2506

                   Offered by: Mr. Davis of Illinois

       Amendment No. 5: Page 7, after line 14, insert the 
     following subsection:
       ``(g) Annual Report.--Beginning with fiscal year 2003, the 
     Director shall annually submit to the Congress a report 
     regarding prevailing disparities in health care delivery as 
     it relates to racial factors, socioeconomic factors, and 
     disease prevalence in priority populations.

                               H.R. 2506

                   Offered by: Mr. Davis of Illinois

       Amendment No. 6: Page 21, line 6, insert after 
     ``agencies,'' the following: ``minority institutions of 
     higher education (such as Historically Black Colleges and 
     Universities, and Hispanic institutions),''.

                               H.R. 2506

                 Offered by: Mr. Thompson of California

       Amendment No. 7: Page 21, after line 8, insert the 
     following subsection:
       ``(d) Medical Examination of Certain Victims.--
       ``(1) In general.--In carrying out subsection (a), the 
     Director shall promote evidence-based clinical practices 
     for--
       ``(A) the examination and treatment by health professionals 
     of individuals who are victims of sexual assault (including 
     child molestation) or attempted sexual assault; and
       ``(B) the training of health professionals on performing 
     medical evidentiary examinations of individuals who are 
     victims of child abuse or neglect, sexual assault, elder 
     abuse, or domestic violence.
       ``(2) Certain considerations.--Evidence-based clinical 
     practices promoted under paragraph (1) shall take into 
     consideration the expertise and experience of Federal and 
     State law enforcement officials regarding the victims 
     referred to in such paragraph, and of other appropriate 
     public and private entities (including medical societies, 
     victim services organizations, sexual assault prevention 
     organizations, and social services organizations).

                               H.R. 2506

                 Offered by: Mr. Thompson of California

       Amendment No. 8: Page 46, after line 2, add the following 
     section:

     SEC. 4. REPORT ON TELEMEDICINE.

       Not later than January 10, 2001, the Director of the Agency 
     for Health Research and Quality shall submit to the Congress 
     a report that--
       (1) identifies any factors that inhibit the expansion and 
     accessibility of telemedicine services, including factors 
     relating to telemedicine networks;
       (2) identifies any factors that, in addition to 
     geographical isolation, should be used to determine which 
     patients need or require access to telemedicine care;
       (3) determines the extent to which--
       (A) patients receiving telemedicine service have benefited 
     from the services, and are satisfied with the treatment 
     received pursuant to the services; and
       (B) the medical outcomes for such patients would have 
     differed if telemedicine services had not been available to 
     the patients;
       (4) determines the extent to which physicians involved with 
     telemedicine services have been satisfied with the medical 
     aspects of the services;
       (5) determines the extent to which primary care physicians 
     are enhancing their medical

[[Page H8558]]

     knowledge and experience through the interaction with 
     specialists provided by telemedicine consultations;
       (6) determines the manner in which the confidentiality of 
     information on patients can be protected when information is 
     transferred via electronic telemedicine networks; and
       (7) identifies legal and medical issues relating to State 
     licensing of health professionals that are presented by 
     telemedicine services, and provides any recommendations of 
     the Director for responding to such issues.

                               H.R. 2506

                        Offered by: Mr. Tierney

       Amendment No. 9: Page 12, after line 14, insert the 
     following subparagraph:
       ``(C) The conduct of research on methods to reduce the 
     costs to consumers of obtaining prescription drugs.
       Page 12, line 15, strike ``(C)'' and insert ``(D)''.

                               H.R. 2506

                        Offered by: Mr. Tierney

       Amendment No. 10: Page 13, after line 5, insert the 
     following subsection:
       ``(d) Studies of Methods to Improve Access to Health 
     Services.--The Director shall conduct, and shall provide 
     scientific and technical support for private and public 
     efforts to conduct, studies of the organization, delivery, 
     and financing of health services in order to determine the 
     cost and quality effects of various methods of substantially 
     increasing the number of individuals in the United States who 
     have access to health services.

                               H.R. 2506

                        Offered by: Mr. Tierney

       Amendment No. 11: Page 13, after line 5, insert the 
     following subsection:
       ``(d) Studies of Methods to Improve Access to Health 
     Services.--The Director shall conduct, and shall provide 
     scientific and technical support for private and public 
     efforts to conduct, studies of the organization, delivery, 
     and financing of health services in order to determine the 
     cost and quality effects of various methods of substantially 
     increasing the number of individuals in the United States who 
     have access to health services. Such studies shall include a 
     study to determine the impact of a single payer insurance 
     coverage program on health expenditures in the United States 
     during the fiscal years 2000 through 2007 compared to the 
     projected impact of the current system on health expenditures 
     in the United States during such period.