[House Report 108-275]
[From the U.S. Government Publishing Office]



108th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 1st Session                                                    108-275
======================================================================
 
  HEALTH CARE SAFETY NET AMENDMENTS TECHNICAL CORRECTIONS ACT OF 2003

                                _______
                                

 September 17, 2003.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

 Mr. Tauzin, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 3038]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 3038) to make certain technical and conforming 
amendments to correct the Health Care Safety Net Amendments of 
2002, having considered the same, report favorably thereon 
without amendment and recommend that the bill do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     1
Background and Need for Legislation..............................     2
Hearings.........................................................     2
Committee Consideration..........................................     2
Committee Votes..................................................     2
Committee Oversight Findings.....................................     2
Statement of General Performance Goals and Objectives............     2
New Budget Authority, Entitlement Authority, and Tax Expenditures     2
Committee Cost Estimate..........................................     3
Congressional Budget Office Estimate.............................     2
Federal Mandates Statement.......................................     3
Advisory Committee Statement.....................................     3
Constitutional Authority Statement...............................     3
Applicability to Legislative Branch..............................     4
Section-by-Section Analysis of the Legislation...................     4
Changes in Existing Law Made by the Bill, as Reported............     4

                          Purpose and Summary

    H.R. 3038 makes technical and conforming changes to the 
Health Care Safety Net Amendments Act of 2002.

                  Background and Need for Legislation

    On October 22, 2002, President Bush signed into law the 
Health Care Safety Net Amendments Act of 2002 (P.L. 107-251), 
legislation to strengthen several public health programs for 
low-income individuals and the underserved, including Community 
Health Centers and the National Health Service Corps. This 
lengthy act amended several sections of the Public Health 
Service Act, albeit incorrectly. H.R. 3038 aligns the U.S. Code 
and makes minor corrections to clarify the original intent of 
Congress in order for the Department of Health and Human 
Services to fully implement the law as designed.

                                Hearings

    The Committee on Energy and Commerce has not held hearings 
on the legislation.

                        Committee Consideration

    On September 10, 2003, the Full Committee met in open 
markup session and favorably ordered H.R. 3038 reported to the 
House by a voice vote, a quorum being present.

                            Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list the record votes 
on the motion to report legislation and amendments thereto. 
There were no record votes taken in connection with ordering 
H.R. 3038 reported. A motion by Mr. Tauzin to order H.R. 3038 
reported to the House, without amendment, was agreed to by a 
voice vote.

                      Committee Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee has not held oversight 
or legislative hearings on this legislation.

         Statement of General Performance Goals and Objectives

    The goal of H.R. 3038 is to make technical and conforming 
changes to the Health Care Safety Net Amendments Act of 2002.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee finds that H.R. 
3038, the Health Care Safety Net Amendments Technical 
Corrections Act of 2003, would result in no new or increased 
budget authority, entitlement authority, or tax expenditures or 
revenues.

                        Committee Cost Estimate

    The Committee adopts as its own the cost estimate prepared 
by the Director of the Congressional Budget Office pursuant to 
section 402 of the Congressional Budget Act of 1974.

                  Congressional Budget Office Estimate

    Pursuant to clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives, the following is the cost estimate 
provided by the Congressional Budget Office pursuant to section 
402 of the Congressional Budget Act of 1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                Washington, DC, September 16, 2003.
Hon. W.J. ``Billy'' Tauzin,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 3038, the Health 
Care Safety Net Amendments Technical Corrections Act of 2003.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Margaret 
Nowak.
            Sincerely,
                                       Douglas Holtz-Eakin,
                                                          Director.
    Enclosure.

H.R. 3038--Health Care Safety Net Amendments Technical Corrections Act 
        of 2003

    H.R. 3038 would make technical and conforming amendments to 
the Health Care Safety Net Amendments of 2002 (Public Law 107-
251). That law reauthorized and expanded the Health Centers and 
National Health Service Corps programs, and established the 
Community Access Program in statute. CBO estimates that the 
bill's changes would have no impact on the Federal budget.
    The bill contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act and 
would impose no costs on State, local, or tribal governments.
    The CBO staff contact is Margaret Nowak. This estimate was 
approved by Peter H. Fontaine, Deputy Assistant Director for 
Budget Analysis.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

                      Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by this 
legislation.

                   Constitutional Authority Statement

    Pursuant to clause 3(d)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee finds that the 
Constitutional authority for this legislation is provided in 
Article I, section 8, clause 3, which grants Congress the power 
to regulate commerce with foreign nations, among the several 
States, and with the Indian tribes.

                  Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

             Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 designates the short title as the ``Health Care 
Safety Net Amendments Technical Corrections Act of 2003.''

Section 2. Technical amendments

    Section 2 makes several technical changes to the Health 
Care Safety Net Amendments Act of 2002 (P.L. 107-251). It 
renumbers and aligns several sections of the Public Health 
Service Act, makes grammatical corrections, including period 
and comma placement, and corrects misnamed references to 
agencies within the Department of Health and Human Services. 
Section 2 makes stand-alone provisions in the Health Care 
Safety Net Amendments Act of 2002, including telemedicine 
incentive grants, part of the Public Health Service Act.
    Section 2 also clarifies the original intent of the Health 
Care Safety Net Amendments Act of 2002. Section 2 replaces 
language inadvertently deleted by the Act to permit the 
Department of Health and Human Services to provide technical 
assistance either through the Department or by grant or 
contract. Further, the technical assistance activities outlined 
under the law are not intended to be an exhaustive list; for 
example, the Department of Health and Human Services could 
provide technical assistance through the planning and 
development of networks. Section 2 amends section 332 of the 
Public Health Service Act to clarify that Federally qualified 
community health centers may be designated as health 
professional shortage areas upon date of designation, not the 
date of the enactment of the law. It further clarifies section 
333A(c)(4) to make priorities in assignment of National Health 
Service Corps personnel within 30 days ``from such 
notification.'' Section 2 clarifies section 338E of the Public 
Health Service Act with regard to loan repayments of National 
Health Service Corps personnel. Finally, section 2 clarifies 
that the Department of Health and Human Services is to conduct 
a study of the Department's ability to provide for 
``guarantees'' of solvency for managed care networks or plans 
involving health centers receiving funding under section 330 of 
the Public Health Service Act.

Section 3. Effective date

    Section 3 sets the effective date immediately after the 
enactment of Public Law 107-251.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

PUBLIC HEALTH SERVICE ACT

           *       *       *       *       *       *       *



         TITLE II--ADMINISTRATION AND MISCELLANEOUS PROVISIONS


Part A--Administration

           *       *       *       *       *       *       *



          defense of certain malpractice and negligence suits

  Sec. 224. (a) * * *

           *       *       *       *       *       *       *

  (g)(1)(A) * * *

           *       *       *       *       *       *       *

  (G) In the case of an entity described in paragraph (4) that 
has not submitted an application under subparagraph (D):
          (i) * * *
          (ii) This section does not affect any authority of 
        the entity to purchase medical malpractice liability 
        insurance coverage with Federal funds provided to the 
        entity under section 329, [330, 330(h)] 330, or 340A.

           *       *       *       *       *       *       *

  (k)(1) * * *
  (2) Subject to appropriations, for each fiscal year, the 
Secretary shall establish a fund of an amount equal to the 
amount estimated under paragraph (1) that is attributable to 
entities receiving funds under each of the grant programs 
described in paragraph (4) of subsection (g), but not to exceed 
a total of $10,000,000 for each such fiscal year. 
Appropriations for purposes of this paragraph shall be made 
separate from appropriations made for purposes of sections 329, 
[330, 330(h)] 330 and 340A.

           *       *       *       *       *       *       *

  (n)(1) Not later than one year after the date of the 
enactment of the Federally Supported Health Centers Assistance 
Act of 1995, the Comptroller General of the United States shall 
submit to the Congress a report on the following:
          (A) * * *

           *       *       *       *       *       *       *

          (C) The value of private sector risk-management 
        services, and the value of risk-management services and 
        procedures required as a condition of receiving a grant 
        under section 329, [330, 330(h)] 330, or 340A.

           *       *       *       *       *       *       *


TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

           *       *       *       *       *       *       *



Part B--Federal-State Cooperation

           *       *       *       *       *       *       *



     SCREENINGS, REFERRALS, AND EDUCATION REGARDING LEAD POISONING

  Sec. 317A. (a) Authority for Grants.--
          (1) * * *
          (2) Authority regarding certain entities.--With 
        respect to a geographic area with a need for activities 
        authorized in paragraph (1), in any case in which 
        neither the State nor the political subdivision in 
        which such area is located has applied for a grant 
        under paragraph (1), the Secretary may make a grant 
        under such paragraph to any grantee under section 329, 
        [330, 330(h)] 330, or 340A for carrying out such 
        activities in the area.

           *       *       *       *       *       *       *


           PREVENTIVE HEALTH SERVICES REGARDING TUBERCULOSIS

  Sec. 317E. (a) * * *

           *       *       *       *       *       *       *

  (c) Cooperation With Providers of Primary Health Services.--
The Secretary may make a grant under subsection (a) or (b) only 
if the applicant for the grant agrees that, in carrying out 
activities under the grant, the applicant will cooperate with 
public and nonprofit private providers of primary health 
services or substance abuse services, including entities 
receiving assistance under section 329, [330, 330(h)] 330, or 
340A or under title V or XIX.

           *       *       *       *       *       *       *


             INFERTILITY AND SEXUALLY TRANSMITTED DISEASES

  Sec. 318A. (a) * * *

           *       *       *       *       *       *       *

  (e) Required Providers Regarding Certain Services.--The 
Secretary may make a grant under subsection (a) only if the 
applicant involved agrees that, in expending the grant to carry 
out activities authorized in subsection (c), the services 
described in paragraphs (1) through (7) of such subsection will 
be provided only through entities that are State or local 
health departments, grantees under section 329, [330, 330(h)] 
330, 340A, or 1001, or are other public or nonprofit private 
entities that provide health services to a significant number 
of low-income women.

           *       *       *       *       *       *       *


                      Part D--Primary Health Care


                       Subpart I--Health Centers


SEC. 330. HEALTH CENTERS.

  (a) * * *

           *       *       *       *       *       *       *

  (c) Planning Grants.--
          (1) In general.--
                  (A) * * *
                  (B) Comprehensive service delivery networks 
                and plans.--The Secretary may make grants to 
                health centers that receive assistance under 
                this section to enable the centers to plan and 
                develop a managed care network or [plan..] 
                plan. Such a grant may only be made for such a 
                center if--
                          (i) * * *

           *       *       *       *       *       *       *

  (d) Managed Care Loan Guarantee Program.--
          (1) Establishment.--
                  (A) * * *
                  (B) Use of funds.--Loan funds guaranteed 
                under this subsection may be used--
                          (i) * * *

           *       *       *       *       *       *       *

                          (iii) to refinance an existing loan 
                        (as of the date of refinancing) to the 
                        center or centers, if the Secretary 
                        determines--
                                  (I) that such refinancing 
                                will be beneficial to the 
                                health center and the Federal 
                                Government; or

           *       *       *       *       *       *       *

  (e) Operating Grants.--
          (1) * * *

           *       *       *       *       *       *       *

          [(3)] (4) Limitation.--Not more than two grants may 
        be made under subparagraph (B) of paragraph (1) for the 
        same entity.
          [(4)] (5) Amount.--
                  (A) In general.--The amount of any grant made 
                in any fiscal year under paragraph (1) to a 
                health center shall be determined by the 
                Secretary, but may not exceed the amount by 
                which the costs of operation of the center in 
                such fiscal year exceed the total of--
                          (i) * * *

           *       *       *       *       *       *       *

  [(n)] (k) Applications.--
          (1) * * *

           *       *       *       *       *       *       *

          (3) Requirements.--Except as provided in subsection 
        (e)(1)(B), the Secretary may not approve an application 
        for a grant under subparagraph (A) or (B) of subsection 
        (e)(1) unless the Secretary determines that the entity 
        for which the application is submitted is a health 
        center (within the meaning of subsection (a)) and 
        that--
                  (A) * * *

           *       *       *       *       *       *       *

                  (H) the center has established a governing 
                board which except in the case of an entity 
                operated by an Indian tribe or tribal or Indian 
                organization under the Indian Self-
                Determination Act or an urban Indian 
                organization under the Indian Health Care 
                Improvement Act (25 U.S.C. 1651 et seq.)--
                          (i) * * *

           *       *       *       *       *       *       *

                except that, upon a showing of good cause the 
                Secretary shall waive, for the length of the 
                project period, all or part of the requirements 
                of this subparagraph in the case of a health 
                center that receives a grant pursuant to 
                subsection (g), (h), (i), [or (q)] or (p);

           *       *       *       *       *       *       *

  [(m) Technical Assistance.--The Secretary shall establish a 
program through which the Secretary shall provide technical and 
other assistance to eligible entities to assist such entities 
to meet the requirements of subsection (l)(3). Services 
provided through the program may include necessary technical 
and nonfinancial assistance, including fiscal and program 
management assistance, training in fiscal and program 
management, operational and administrative support, and the 
provision of information to the entities of the variety of 
resources available under this title and how those resources 
can be best used to meet the health needs of the communities 
served by the entities.]
  (l) Technical Assistance.--The Secretary shall establish a 
program through which the Secretary shall provide (either 
through the Department of Health and Human Services or by grant 
or contract) technical and other assistance to eligible 
entities to assist such entities to meet the requirements of 
subsection (k)(3). Services provided through the program may 
include necessary technical and nonfinancial assistance, 
including fiscal and program management assistance, training in 
fiscal and program management, operational and administrative 
support, and the provision of information to the entities of 
the variety of resources available under this title and how 
those resources can be best used to meet the health needs of 
the communities served by the entities.
  [(p)] (m) Memorandum of Agreement.--In carrying out this 
section, the Secretary may enter into a memorandum of agreement 
with a State. Such memorandum may include, where appropriate, 
provisions permitting such State to--
          (1) * * *

           *       *       *       *       *       *       *

  [(q)] (n) Records.--
          (1) * * *

           *       *       *       *       *       *       *

  [(r)] (o) Delegation of Authority.--The Secretary may 
delegate the authority to administer the programs authorized by 
this section to any office, except that the authority to enter 
into, modify, or issue approvals with respect to grants or 
contracts may be delegated only within the central office of 
the Health Resources and Services Administration.
  [(s)] (p) Special Consideration.--In making grants under this 
section, the Secretary shall give special consideration to the 
unique needs of sparsely populated rural areas, including 
giving priority in the awarding of grants for new health 
centers under subsections (c) and (e), and the granting of 
waivers as appropriate and permitted under subsections 
(b)(1)(B)(i) and [(j)(3)(G)] (k)(3)(G).

           *       *       *       *       *       *       *

  [(s)] (r) Authorization of Appropriations.--
          (1) In general.--For the purpose of carrying out this 
        section, in addition to the amounts authorized to be 
        appropriated under subsection (d), there are authorized 
        to be appropriated [$802,124,000 for fiscal year 1997, 
        and such sums as may be necessary for each of the 
        fiscal years 1998 through 2001.] $1,340,000,000 for 
        fiscal year 2002 and such sums as may be necessary for 
        each of the fiscal years 2003 through 2006.
          (2) Special provisions.--
                  (A) Public centers.--The Secretary may not 
                expend in any fiscal year, for grants under 
                this section to public centers (as defined in 
                the second sentence of subsection [(j)(3))] 
                (k)(3)) the governing boards of which (as 
                described in subsection [(j)(3)(G)(ii)] 
                (k)(3)(H)) do not establish general policies 
                for such centers, an amount which exceeds 5 
                percent of the amounts appropriated under this 
                section for that fiscal year. For purposes of 
                applying the preceding sentence, the term 
                ``public centers'' shall not include health 
                centers that receive grants pursuant to 
                subsection (h) or (i).
                  [(B) Distribution of grants.--
                          [(i) Fiscal year 1997.--For fiscal 
                        year 1997, the Secretary, in awarding 
                        grants under this section shall ensure 
                        that the amounts made available under 
                        each of subsections (g), (h), and (i) 
                        in such fiscal year bears the same 
                        relationship to the total amount 
                        appropriated for such fiscal year under 
                        paragraph (1) as the amounts 
                        appropriated for fiscal year 1996 under 
                        each of sections 329, 340, and 340A (as 
                        such sections existed one day prior to 
                        the date of enactment of this section) 
                        bears to the total amount appropriated 
                        under sections 329, 330, 340, and 340A 
                        (as such sections existed one day prior 
                        to the date of enactment of this 
                        section) for such fiscal year.
                          [(ii) Fiscal years 1998 and 1999.--
                        For each of the fiscal years 1998 and 
                        1999, the Secretary, in awarding grants 
                        under this section shall ensure that 
                        the proportion of the amounts made 
                        available under each of subsections 
                        (g), (h), and (i) is equal to the 
                        proportion of amounts made available 
                        under each such subsection for the 
                        previous fiscal year, as such amounts 
                        relate to the total amounts 
                        appropriated for the previous fiscal 
                        year involved, increased or decreased 
                        by not more than 10 percent.]
                  (B) Distribution of grants.--For fiscal year 
                2002 and each of the following fiscal years, 
                the Secretary, in awarding grants under this 
                section, shall ensure that the proportion of 
                the amount made available under each of 
                subsections (g), (h), and (i), relative to the 
                total amount appropriated to carry out this 
                section for that fiscal year, is equal to the 
                proportion of the amount made available under 
                that subsection for fiscal year 2001, relative 
                to the total amount appropriated to carry out 
                this section for fiscal year 2001.

           *       *       *       *       *       *       *


SEC. 330A. RURAL HEALTH CARE SERVICES OUTREACH, RURAL HEALTH NETWORK 
                    DEVELOPMENT, AND SMALL HEALTH CARE PROVIDER QUALITY 
                    IMPROVEMENT GRANT PROGRAMS.

  (a) * * *
  (b) Definitions.--
          (1) * * *

           *       *       *       *       *       *       *

          (4) Medically underserved community.--The term 
        ``medically underserved community'' has the meaning 
        given the term in section [799B] 799B(6).

           *       *       *       *       *       *       *


SEC. 330I. TELEHEALTH NETWORK AND TELEHEALTH RESOURCE CENTERS GRANT 
                    PROGRAMS.

  (a) Definitions.--In this section:
          (1) * * *

           *       *       *       *       *       *       *

          (4) Medically underserved area.--The term ``medically 
        underserved area'' has the meaning given the term 
        ``medically underserved community'' in section [799B] 
        799B(6).

           *       *       *       *       *       *       *

  (c) Administration.--
          (1) Establishment.--There is established in the 
        [Health and Resources and Services Administration] 
        Health Resources and Services Administration an Office 
        for the Advancement of Telehealth. The Office shall be 
        headed by a Director.

           *       *       *       *       *       *       *


SEC. 330K. MENTAL HEALTH SERVICES DELIVERED VIA TELEHEALTH.

  (a) * * *
  (b) Program Authorized.--
          (1) * * *
          (2) Populations served.--The Secretary shall award 
        the grants under paragraph (1) in a manner that 
        distributes the grants so as to serve equitably the 
        populations described in subparagraphs (A) and (B) of 
        subsection [(a)(4)] (a)(3).
  (c) Use of Funds.--
          (1) In general.--An eligible entity that receives a 
        grant under this section shall use the grant funds--
                  (A) for the populations described in 
                subsection [(a)(4)(A)] (a)(3)(A)--
                          (i) * * *

           *       *       *       *       *       *       *

                  (B) for the populations described in 
                subsection [(a)(4)(B)] (a)(3)(B)--
                          (i) * * *

           *       *       *       *       *       *       *


SEC. 330L. TELEMEDICINE; INCENTIVE GRANTS REGARDING COORDINATION AMONG 
                    STATES.

  (a) In General.--The Secretary may make grants to State 
professional licensing boards to carry out programs under which 
such licensing boards of various States cooperate to develop 
and implement State policies that will reduce statutory and 
regulatory barriers to telemedicine.
  (b) Authorization of Appropriations.--For the purpose of 
carrying out subsection (a), there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2002 through 2006.

Subpart II--National Health Service Corps Program

           *       *       *       *       *       *       *


           designation of health professional shortage areas

  Sec. 332. (a)(1) For purposes of this subpart the term 
``health professional shortage area'' means (A) an area in an 
urban or rural area (which need not conform to the geographic 
boundaries of a political subdivision and which is a rational 
area for the delivery of health services) which the Secretary 
determines has a health manpower shortage, (B) a population 
group which the Secretary determines has such a shortage, or 
(C) a public or nonprofit private medical facility or other 
public facility which the Secretary determines has such a 
shortage. All Federally qualified health centers and rural 
health clinics, as defined in section 1861(aa) of the Social 
Security Act (42 U.S.C. 1395x(aa)), that meet the requirements 
of section 334 shall be automatically designated as having such 
a shortage. Not earlier than 6 years after [such date of 
enactment] such date of designation, and every 6 years 
thereafter, each such center or clinic shall demonstrate that 
the center or clinic meets the applicable requirements of the 
Federal regulations[, issued after the date of enactment of 
this Act, that revise] regarding the definition of a health 
professional shortage area for purposes of this section. The 
Secretary shall not remove an area from the areas determined to 
be health professional shortage areas under subparagraph (A) of 
the preceding sentence until the Secretary has afforded 
interested persons and groups in such area an opportunity to 
provide data and information in support of the designation as a 
health professional shortage area or a population group 
described in subparagraph (B) of such sentence or a facility 
described in subparagraph (C) of such sentence, and has made a 
determination on the basis of the data and information 
submitted by such persons and groups and other data and 
information available to the Secretary.

           *       *       *       *       *       *       *

  (3) Homeless individuals (as defined in section [330(h)(4)] 
330(h)(5)), seasonal agricultural workers (as defined in 
section 330(g)(3)) and migratory agricultural workers (as so 
defined)), and residents of public housing (as defined in 
section 3(b)(1) of the United States Housing Act of 1937 (42 
U.S.C. 1437a(b)(1))) may be population groups under paragraph 
(1).
  (b) The Secretary shall establish by regulation criteria for 
the designation of areas, population groups, medical 
facilities, and other public facilities, in the States, as 
health professional shortage areas. In establishing such 
criteria, the Secretary shall take into consideration the 
following:
          (1) * * *
          (2) Indicators of a need, notwithstanding the supply 
        of health manpower, for health services for the 
        individuals in an area or population group or served by 
        a medical facility or other public facility under 
        consideration for [designation,.] designation.

           *       *       *       *       *       *       *

  (j)(1) The Secretary shall submit the report described in 
paragraph (2) if the Secretary, acting through the 
Administrator of the Health Resources and Services 
Administration, issues--
          (A) a regulation that revises the definition of a 
        health professional shortage area for purposes of this 
        section; or
          (B) a regulation that revises the standards 
        concerning priority of such an area under section 333A.
  (2) On issuing a regulation described in paragraph (1), the 
Secretary shall prepare and submit to the Committee on Energy 
and Commerce of the House of Representatives and the Committee 
on Health, Education, Labor, and Pensions of the Senate a 
report that describes the regulation.
  (3) Each regulation described in paragraph (1) shall take 
effect 180 days after the committees described in paragraph (2) 
receive a report referred to in such paragraph describing the 
regulation.

                     assignment of corps personnel

  Sec. 333. (a)(1) The Secretary may assign members of the 
Corps to provide, under regulations promulgated by the 
Secretary, health services in or to a health professional 
shortage area during the assignment period only if--
          (A) * * *

           *       *       *       *       *       *       *

          (C) the entity agrees to comply with the requirements 
        of section 334; and

           *       *       *       *       *       *       *


SEC. 333A. PRIORITIES IN ASSIGNMENT OF CORPS PERSONNEL.

  (a) * * *

           *       *       *       *       *       *       *

  (c) Notifications Regarding Priorities.--
          (1) * * *

           *       *       *       *       *       *       *

          (4) Revisions.--If the Secretary proposes to make a 
        revision in the list under paragraph (2), and the 
        revision would adversely alter the status of an entity 
        with respect to the list, the Secretary shall notify 
        the entity of the revision. Any entity adversely 
        affected by such a revision shall be notified in 
        writing by the Secretary of the reasons for the 
        revision and shall have [30 days] 30 days from such 
        notification to file a written appeal of the 
        determination involved which shall be reasonably 
        considered by the Secretary before the revision to the 
        list becomes final. The revision to the list shall be 
        effective with respect to assignment of Corps members 
        beginning on the date that the revision becomes final.

           *       *       *       *       *       *       *


SEC. 334. CHARGES FOR SERVICES BY ENTITIES USING CORPS MEMBERS.

  (a) * * *
  (b) Charges for Services.--The following rules shall apply to 
charges for health care services provided by an entity to which 
a Corps member is assigned:
          (1) In general.--
                  (A) * * *
                  (B) Schedule of discounts.--Except as 
                provided in paragraph (2), the entity shall 
                prepare a corresponding schedule of discounts 
                (including, in appropriate cases, waivers) to 
                be applied to the payment of such fees or 
                payments. In preparing the schedule, the entity 
                shall adjust the discounts on the basis of a 
                patient's ability to pay.

           *       *       *       *       *       *       *


Subpart III--Scholarship Program and Loan Repayment Program

           *       *       *       *       *       *       *


           NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP PROGRAM

  Sec. 338A. (a) * * *

           *       *       *       *       *       *       *

  (d)(1) Subject to section 333A, in providing contracts under 
the Scholarship Program--
          (A) * * *
          (B) the Secretary, in considering applications from 
        individuals accepted for enrollment or enrolled in 
        dental school, shall consider applications from all 
        individuals accepted for enrollment or enrolled in any 
        accredited dental school in a State; and

           *       *       *       *       *       *       *


SEC. 338B. NATIONAL HEALTH SERVICE CORPS LOAN REPAYMENT PROGRAM.

  (a) * * *

           *       *       *       *       *       *       *

  (e) Approval Required for [Participation.--
          [An individual]
Participation.--An individual becomes a participant in the Loan 
Repayment Program only upon the Secretary and the individual 
entering into a written contract described in subsection (f).

           *       *       *       *       *       *       *


       breach of scholarship contract or loan repayment contract

  Sec. 338E. (a) * * *

           *       *       *       *       *       *       *

  (c)(1) If (for any reason not specified in subsection (a) or 
section 338G(d)) an individual breaches the written contract of 
the individual under section 338B by failing either to begin 
such individual's service obligation in accordance with section 
338C or 338D or to complete such service obligation, the United 
States shall be entitled to recover from the individual an 
amount equal to the sum of--
          (A) the total of the amounts paid by the United 
        States under section 338B(g) on behalf of the 
        individual for any period of obligated service not 
        served;
          (B) an amount equal to the product of the number of 
        months of obligated service that were not completed by 
        the individual, multiplied by $7,500; and
          (C) the interest on the amounts described in 
        subparagraphs (A) and (B), at the maximum legal 
        prevailing rate, as determined by the Treasurer of the 
        United States, from the date of the breach;
except that the amount the United States is entitled to recover 
under this paragraph shall not be less than $31,000.

           *       *       *       *       *       *       *

  (f) The amendment made by section 313(a)(4) of the Health 
Care Safety Net Amendments of 2002 (Public Law 107-251) shall 
apply to any obligation for which a discharge in bankruptcy has 
not been granted before the date that is 31 days after the date 
of enactment of such Act.

           *       *       *       *       *       *       *


TITLE XIII--HEALTH MAINTENANCE ORGANIZATIONS

           *       *       *       *       *       *       *


  limitation on source of funding for health maintenance organizations

  Sec. 1313. No funds appropriated under any provision of this 
Act (except as provided in sections [329, 330, and 330(h)] 329 
and 330) other than this title may be used--
          (1) * * *

           *       *       *       *       *       *       *


TITLE XXVI--HIV HEALTH CARE SERVICES PROGRAM

           *       *       *       *       *       *       *


                  Part C--Early Intervention Services

Subpart I--Categorical Grants

           *       *       *       *       *       *       *


SEC. 2652. MINIMUM QUALIFICATIONS OF GRANTEES.

  (a) In General.--The entities referred to in section 2651(a) 
are public entities and nonprofit private entities that are--
          (1) * * *
          (2) grantees under section [340] 330(h) (regarding 
        health services for the homeless);

           *       *       *       *       *       *       *

                              ----------                              


HEALTH CARE SAFETY NET AMENDMENTS ACT OF 2002

           *       *       *       *       *       *       *


TITLE I--CONSOLIDATED HEALTH CENTER PROGRAM AMENDMENTS

           *       *       *       *       *       *       *


[SEC. 102. TELEMEDICINE; INCENTIVE GRANTS REGARDING COORDINATION AMONG 
                    STATES.

  [(a) In General.--The Secretary of Health and Human Services 
may make grants to State professional licensing boards to carry 
out programs under which such licensing boards of various 
States cooperate to develop and implement State policies that 
will reduce statutory and regulatory barriers to telemedicine.
  [(b) Authorization of Appropriations.--For the purpose of 
carrying out subsection (a), there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2002 through 2006.]

           *       *       *       *       *       *       *


TITLE III--NATIONAL HEALTH SERVICE CORPS PROGRAM

           *       *       *       *       *       *       *


SEC. 302. DESIGNATION OF HEALTH PROFESSIONAL SHORTAGE AREAS.

  (a) * * *
  [(b) Regulations.--
          [(1) Report.--
                  [(A) In general.--The Secretary shall submit 
                the report described in subparagraph (B) if the 
                Secretary, acting through the Administrator of 
                the Health Resources and Services 
                Administration, issues--
                          [(i) a regulation that revises the 
                        definition of a health professional 
                        shortage area for purposes of section 
                        332 of the Public Health Service Act 
                        (42 U.S.C. 254e); or
                          [(ii) a regulation that revises the 
                        standards concerning priority of such 
                        an area under section 333A of that Act 
                        (42 U.S.C. 254f-1).
                  [(B) Report.--On issuing a regulation 
                described in subparagraph (A), the Secretary 
                shall prepare and submit to the Committee on 
                Energy and Commerce of the House of 
                Representatives and the Committee on Health, 
                Education, Labor, and Pensions of the Senate a 
                report that describes the regulation.
          [(2) Effective date.--Each regulation described in 
        paragraph (1)(A) shall take effect 180 days after the 
        committees described in paragraph (1)(B) receive a 
        report referred to in paragraph (1)(B) describing the 
        regulation.]

           *       *       *       *       *       *       *


SEC. 313. BREACH OF SCHOLARSHIP CONTRACT OR LOAN REPAYMENT CONTRACT.

  (a) * * *
  [(b) Effective Date.--The amendment made by subsection (a)(4) 
shall apply to any obligation for which a discharge in 
bankruptcy has not been granted before the date that is 31 days 
after the date of enactment of this Act.]

           *       *       *       *       *       *       *


TITLE IV--HEALTHY COMMUNITIES ACCESS PROGRAM

           *       *       *       *       *       *       *


SEC. 404. STUDY REGARDING BARRIERS TO PARTICIPATION OF FARMWORKERS IN 
                    HEALTH PROGRAMS.

  (a) * * *

           *       *       *       *       *       *       *

  (c) Consultations.--In conducting the study, the Secretary 
shall consult with the following:
          (1) * * *

           *       *       *       *       *       *       *

          (5) Representatives of Federal agencies which are 
        involved in the provision or financing of health care 
        to farmworkers, including the [Health Care Financing 
        Administration and the Health Research] Centers for 
        Medicare & Medicaid Services and the Health Resources 
        and Services Administration.

           *       *       *       *       *       *       *


              TITLE V--STUDY AND MISCELLANEOUS PROVISIONS

SEC. 501. GUARANTEE STUDY.

  The Secretary of Health and Human Services shall conduct a 
study regarding the ability of the Department of Health and 
Human Services to provide for [solvency for managed care 
networks] guarantees of solvency for managed care networks or 
plans involving health centers receiving funding under section 
330 of the Public Health Service Act. The Secretary shall 
prepare and submit a report to the appropriate Committees of 
Congress regarding such ability not later than 2 years after 
the date of enactment of the Health Care Safety Net Amendments 
of 2002.

           *       *       *       *       *       *       *


                                
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