Input:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Durable Medical Equipment
Patient Protection Act of 1993''.

SEC. 2. RESTRICTIONS ON CARRIERS.

    (a) Limit on Number of Regional Carriers; Prohibition Against
Carrier Forum Shopping.--Section 1834(a)(12) of the Social Security Act
(42 U.S.C. 1395m(a)(12)) is amended to read as follows:
            ``(12) Use of carriers to process claims.--
                    ``(A) Designation of regional carriers.--The
                Secretary may designate, by regulation under section
                1842, one carrier for one or more entire regions (but
                not more than 5 for all regions) to process all claims
                within the region for covered items under this section.
                    ``(B) Prohibition against carrier forum shopping.--
                (i) No supplier of a covered item may present or cause
                to be presented a claim for payment under this part
                unless such claim is presented to the appropriate
                carrier.
                    ``(ii) For purposes of clause (i), the term
                `appropriate carrier' means the carrier having
                jurisdiction over the geographic area of the residence
                of the patient to whom the item is furnished, except
                that--
                            ``(I) in the case of a patient who resides
                        not more than 60 miles from a geographic area
                        over which a second carrier has jurisdiction,
                        such term may include the second carrier;
                            ``(II) in the case of a patient who, at the
                        time the item that is the subject of the claim
                        is furnished, is temporarily residing in a
                        geographic area other than the area of the
                        patient's residence, such term may include the
                        carrier having jurisdiction over the geographic
                        area in which the patient temporarily resides;
                        and
                            ``(III) such term may include any other
                        carrier considered by the Secretary to be the
                        most appropriate carrier with respect to the
                        claim (based on the need to efficiently
                        administer the processing of the claim).''.
    (b) Effective Date.--The amendments made by subsection (a) shall
apply with respect to contracts with carriers for items furnished on or
after January 1, 1994.

SEC. 3. TREATMENT OF CERTAIN ITEMS AS COVERED ITEMS; USING REASONABLE
              COST AS BASIS FOR DETERMINING PAYMENT AMOUNTS.

    (a) Treatment of Certain Items as Covered Items.--
            (1) In general.--Section 1861(n) of the Social Security Act
        (42 U.S.C. 1395x(n)) is amended by striking ``iron lungs'' and
        inserting ``ostomy supplies, tracheostomy supplies,
        urologicals, surgical dressings and splints, casts, and other
        devices used for reduction of fractures and dislocations, iron
        lungs''.
            (2) Treatment as inexpensive and routinely purchased
        items.--Section 1834(a)(2)(A) of such Act (42 U.S.C.
        1395m(a)(2)(A)) is amended
                    (A) by striking ``or'' at the end of clause (i);
                    (B) by striking the comma at the end of clause (ii)
                and inserting ``, or''; and
                    (C) by inserting after clause (ii) the following
                new clause:
                            ``(iii) which consists of an ostomy supply,
                        tracheostomy supply, urological, or surgical
                        dressing or splint, cast, or other device used
                        for reduction of fractures and dislocations,''.
            (3) Conforming amendments.--(A) Section 1834(h)(4)(C) of
        such Act (42 U.S.C. 1395m(h)(4)(C)) is amended by striking ``,
        catheter supplies'' and all that follows through ``ostomy
        care'' and inserting ``and catheter supplies''.
            (B) Section 1861(s) of such Act (42 U.S.C. 1395x(s)) is
        amended--
                    (i) by striking paragraph (5); and
                    (ii) in paragraph (9), by striking the semicolon at
                the end and inserting the following: ``, but not
                including ostomy supplies, tracheostomy supplies, or
                urologicals;''.
            (4) Effective date.--The amendments made by this subsection
        shall apply to items furnished on or after January 1, 1994.
    (b) Study of Feasibility of Basing Payment Amounts on Reasonable
Costs.--
            (1) Study.--The Secretary of Health and Human Services, in
        consultation with carriers under part B of the medicare program
        and representatives of suppliers of durable medical equipment
        under the program, shall conduct a study of the feasibility and
        desirability of basing payment amounts for covered items of
        durable medical equipment, prosthetic devices, and orthotics
        and prosthetics under such program on the reasonable costs of
        such items.
            (2) Report.--Not later than January 1, 1995, the Secretary
        shall submit a report on the study conducted under paragraph
        (1) to Congress, and shall include in the report any
        recommendations considered appropriate by the Secretary for
        changes in the manner in which payment amounts are determined
        under the medicare program for the items that are the subject
        of the study.
    (c) Guidelines for Determining Medical Effectiveness and Permitting
Payment for Upgraded Items.--Not later than January 1, 1995, the
Secretary of Health and Human Services shall establish and publish
updated guidelines for carriers under part B of the medicare program
that describe the conditions under which--
            (1) covered items of durable medical equipment, prosthetic
        devices, and orthotics and prosthetics shall be considered
        medically effective when furnished to an elderly patient and
        when furnished to a disabled patient; and
            (2) a supplier of such items may furnish a patient with an
        item in excess of or more expensive than the standard version
        of the item for which payment may be made under the program.

SEC. 4. CERTIFICATION AND DISCLOSURE REQUIREMENTS FOR SUPPLIERS OF
              DURABLE MEDICAL EQUIPMENT.

    (a) Mandatory Supplier Certification.--
            (1) In general.--Section 1834(a) of the Social Security Act
        (42 U.S.C. 1395m(a)) is amended by adding at the end the
        following new paragraph:
            ``(17) Certification of suppliers.--
                    ``(A) In general.--Notwithstanding any other
                provision of this Act, no payment may be made under
                this part for any covered item furnished during a year
                (beginning with 1994) by any supplier unless the
                Secretary certifies (or has certified during the 4
                years preceding the year) that the supplier meets the
                certification standards established under subparagraph
                (B).
                    ``(B) Establishment of standards.--The Secretary
                shall establish and publish certification standards for
                suppliers on the basis of such criteria as the
                Secretary considers appropriate, and shall include in
                the standards a requirement that the supplier furnish
                the Secretary with the following information:
                            ``(i) Whether the items furnished by the
                        supplier are purchased, warehoused, and shipped
                        directly by the supplier or under arrangements
                        with other suppliers.
                            ``(ii) The identity of subcontracting or
                        subsidiary entities or entities with which the
                        provider is doing business which are
                        advertising or marketing firms directly or
                        indirectly involved in furnishing covered items
                        to individuals entitled to benefits under this
                        title.
                            ``(iii) A description of all items and
                        services furnished by the supplier to
                        individuals eligible for benefits under this
                        title and to providers of services or other
                        entities furnishing items and services for
                        which payment may be made under this title.
                            ``(iv) A list of all States and counties in
                        which individuals reside to whom the supplier
                        furnishes items or services for which payment
                        is made under this title or under a State plan
                        for medical assistance under title XIX.
                            ``(v) Any additional information the
                        Secretary considers appropriate.
                    ``(C) Fees authorized for certification.--The
                Secretary of Health and Human Services may require a
                supplier to make a payment of an administrative fee
                (not to exceed $100) with respect to a certification or
                renewal of a certification under this paragraph. Any
                fees collected by the Secretary pursuant to this
                subparagraph shall be deposited in the Federal
                Supplementary Medical Insurance Trust Fund and shall be
                available only for the administration of this part.
                    ``(D) Waiver of requirements for certain
                suppliers.--The Secretary may waive or modify any of
                the certification standards established under
                subparagraph (B) or the payment of a fee required under
                subparagraph (C) with respect to a supplier if the
                Secretary determines that the majority of the items
                furnished by the supplier are inexpensive or routinely
                purchased items under paragraph (2) or that less than
                25 percent of the supplier's annual gross revenues is
                attributable to the furnishing of covered items under
                this title.''.
            (2) Conforming amendment.--Section 1834(h)(3) of such Act
        (42 U.S.C. 1395m(h)(3)) is amended by striking ``Paragraph
        (12)'' and inserting ``Paragraphs (12) and (17)''.
    (b) Prohibition Against Issuance of Multiple Provider Numbers.--
Section 1834(a)(12) of such Act (42 U.S.C. 1395m(a)(12)), as amended by
section 2(a), is further amended by adding at the end the following new
subparagraph:
                    ``(C) Prohibition against issuance of multiple
                provider numbers.--A carrier may not issue more than
                one provider number to a supplier of a covered item
                unless the issuance of multiple provider numbers is
                appropriate because of significant differences among
                the items the supplier furnishes or the geographic
                regions the provider serves. Nothing in the previous
                sentence shall be construed to prohibit a carrier from
                issuing a new provider number to a supplier to replace
                an inactive or obsolete provider number.''.
    (c) Limitation on Employment Relationships Considered Bona Fide for
Exemption from Anti-Kickback Requirements.--Section 1128B(b)(3)(B) of
such Act (42 U.S.C. 1320a-7b(b)(3)(B)) is amended by striking the
semicolon at the end and inserting the following: ``, except that any
employment relationship between an employee of a nursing facility and a
supplier of covered items under section 1834(a) or items described in
section 1834(h) shall not be considered a bona fide employment
relationship for purposes of this subparagraph;''.
    (d) Effective Date.--The amendments made by this section shall
apply with respect to items or services furnished on or after January
1, 1994.

SEC. 5. PRIOR APPROVAL AUTHORIZED FOR ITEMS FURNISHED BY SUPPLIERS
              ENGAGED IN FRAUD OR OTHER ABUSIVE PRACTICES.

    (a) In General.--Section 1834(a) of the Social Security Act (42
U.S.C. 1395m(a)), as amended by section 4(a), is further amended by
adding at the end the following new paragraph:
            ``(18) Carrier determinations of items furnished by certain
        suppliers in advance.--
                    ``(A) Development of list of suppliers by
                secretary.--The Secretary shall develop and
                periodically update a list of suppliers that the
                Secretary determines (on the basis of criteria
                developed and published by the Secretary in
                consultation with representatives of suppliers, which
                may include prior payment experience)--
                            ``(i) have engaged in activities which make
                        the suppliers subject to a civil monetary
                        penalty under section 1128A or to a criminal
                        penalty under section 1128B;
                            ``(ii) have furnished a substantial number
                        of items for which payment was not made because
                        of the application of section 1862(a)(1); or
                            ``(iii) have engaged in a pattern of
                        overutilization of items.
                    ``(B) Determinations of coverage in advance.--A
                carrier shall determine in advance whether payment for
                an item furnished by a supplier included on the list
                developed by the Secretary under subparagraph (A) may
                not be made because of the application of section
                1862(a)(1).''.
    (b) Conforming Amendment.--Section 1834(h)(3) of such Act (42
U.S.C. 1395m(h)(3)), as amended by section 4(a)(2), is amended by
striking ``(12) and (17)'' and inserting ``(12), (15), (17), and
(18)''.
    (c) Effective Date.--The amendments made by this section shall
apply to items and services furnished on or after January 1, 1994.

SEC. 6. STUDY OF IMPACT OF REFORMS ON ACCESS TO AND COSTS OF DURABLE
              MEDICAL EQUIPMENT FOR MEDICARE BENEFICIARIES.

    (a) Study.--
            (1) In general.--The Comptroller General shall conduct a
        study of the impact of the amendments made by this Act on the
        access of individuals enrolled under part B of the medicare
        program to items of durable medical equipment under the program
        and the costs imposed on such individuals under the program for
        such items, and shall include in the study an analysis of the
        impact of the amendments on individuals enrolled under part B
        of the program who reside in rural areas.
            (2) Durable medical equipment defined.--For purposes of
        paragraph (1), the term ``durable medical equipment'' means
        covered items under section 1834(a) of the Social Security Act
        and items described in section 1834(h) of such Act.
    (b) Report.--Not later than January 1, 1995, the Comptroller
General shall submit a report to Congress on the study conducted under
subsection (a), and shall include in the report any recommendations
considered appropriate for legislative or regulatory changes to improve
the access of medicare beneficiaries to items of durable medical
equipment and to control the costs imposed on beneficiaries for such
items under the medicare program, including recommendations to impose
maximum allowable limits on the amounts suppliers of such items may
charge beneficiaries in the same manner as the limits imposed under the
program on the amounts physicians may charge beneficiaries for
physicians' services.

SEC. 7. STUDY OF ITEMS FURNISHED TO RESIDENTS OF NURSING FACILITIES.

    (a) Study.--
            (1) In general.--The Comptroller General shall conduct a
        study of the types, volume, and utilization of items of durable
        medical equipment furnished under part B of the medicare
        program to individuals residing in skilled nursing facilities
        and intermediate care facilities, and shall include in the
        study an analysis of the need to apply additional controls on
        the utilization of such items by such individuals.
            (2) Durable medical equipment defined.--For purposes of
        paragraph (1), the term ``durable medical equipment'' means
        covered items under section 1834(a) of the Social Security Act
        and items described in section 1834(h) of such Act.
    (b) Report.--Not later than January 1, 1995, the Comptroller
General shall submit a report to Congress on the study conducted under
subsection (a).

Output:
Medicare Durable Medical Equipment Patient Protection Act of 1993 - (Sec. 2) Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services to designate no more than five regional carriers nationwide to process all claims for durable medical equipment (DME).
Prohibits a supplier from presenting a claim for payment unless such claim is presented to the appropriate carrier (i.e., the carrier having jurisdiction over the geographic area of the residence of the patient to whom the item is furnished, with exceptions).
(Sec. 3) Includes:  (1) within the definition of "DME" ostomy and tracheostomy supplies, urologicals, surgical dressings, and splints, casts, and other devices used for reduction of fractures and dislocations; and (2) such supplies in the category of inexpensive and other routinely purchased equipment for payment purposes.
Directs the Secretary to:  (1) report to the Congress on the feasibility and desirability of basing payment amounts for covered items of DME, prosthetic devices, and orthotics and prosthetics on the reasonable costs of such items; and (2) publish updated guidelines for carriers describing conditions under which such items shall be considered medically effective when furnished to an elderly patient or a disabled patient, and under which a supplier may furnish a patient with an item in excess of, or more expensive than, the standard version for which payment may be made under the program.
(Sec. 4) Specifies that no payment may be made unless the supplier meets specified certification standards.
Directs the Secretary to establish certification standards for suppliers.
Authorizes the Secretary to require  suppliers to pay an administrative fee and waive or modify certification standards or fee payment under certain circumstances.
Prohibits a carrier from issuing more than one provider number to a supplier unless there are significant differences among the items the supplier furnishes or the geographic regions the provider serves.
Provides that anti-kickback requirements shall not apply to amounts paid to employees for provision of covered items or services (as under current law), except that any employment relationship between an employee of a nursing facility and a supplier shall not be considered a bona fide employment relationship.
(Sec. 5) Directs the Secretary to develop a list of suppliers determined to have:  (1) engaged in activities which subject them to specified civil or criminal monetary penalties; (2) furnished a substantial number of items for which payment was not made; or (3) engaged in a pattern of overutilization of items.  Requires carriers to determine in advance whether payment for an item furnished by a listed supplier may not be made because of coverage exclusions.
(Secs. 6 and 7) Directs the Comptroller General to study and report to the Congress on:  (1) the impact of this Act on access to, and costs of, DME for Medicare beneficiaries; and (2) the types, volume, and utilization of DME furnished to Medicare beneficiaries residing in skilled nursing and intermediate care facilities.  Sets forth reporting requirements.


Input:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Organic Standards Protection Act''.

SEC. 2. RECORDKEEPING, INVESTIGATIONS, AND ENFORCEMENT.

    The Organic Foods Production Act of 1990 is amended by inserting
after section 2120 (7 U.S.C. 6519) the following:

``SEC. 2120A. RECORDKEEPING, INVESTIGATIONS, AND ENFORCEMENT.

    ``(a) Recordkeeping.--
            ``(1) In general.--Except as otherwise provided in this
        title, all persons, including producers, handlers, and
        certifying agents, required to report information to the
        Secretary under this title shall maintain, and make available
        to the Secretary on the request of the Secretary, all
        contracts, agreements, receipts, and other records associated
        with the organic certification program established by the
        Secretary under this title.
            ``(2) Duration of recordkeeping requirement.--A record
        covered by paragraph (1) shall be maintained--
                    ``(A) by a person covered by this title, except for
                a certifying agent, for a period of 5 years beginning
                on the date of the creation of the record; and
                    ``(B) by a certifying agent, for a period of 10
                years beginning on the date of the creation of the
                record.
    ``(b) Confidentiality.--
            ``(1) In general.--Subject to paragraph (2), and except as
        otherwise directed by the Secretary or the Attorney General for
        enforcement purposes, no officer, employee, or agent of the
        United States shall make available to the public information,
        statistics, or documents obtained from or made available by any
        person under this title, other than in a manner that ensures
        that confidentiality is preserved regarding the identity of
        persons, including parties to a contract, and proprietary
        business information.
            ``(2) Alleged violators and nature of actions.--The
        Secretary may release the name of the alleged violator and the
        nature of the actions triggering an order or revocation under
        subsection (e).
    ``(c) Investigation.--
            ``(1) In general.--The Secretary may take such
        investigative actions as the Secretary considers to be
        necessary to carry out this title--
                    ``(A) to verify the accuracy of any information
                reported or made available under this title; and
                    ``(B) to determine, with regard to actions,
                practices, or information required under this title,
                whether a person covered by this title has committed,
                or will commit, a violation of any provision of this
                title.
            ``(2) Investigative powers.--The Secretary may administer
        oaths and affirmations, subpoena witnesses, compel attendance
        of witnesses, take evidence, and require the production of any
        books, papers, and documents that are relevant to the
        investigation.
    ``(d) Unlawful Act.--It shall be unlawful and a violation of this
title for any person covered by this title--
            ``(1) to fail or refuse to provide, or delay the timely
        provision of, accurate information required by the Secretary
        under this section;
            ``(2) to violate--
                    ``(A) an order of the Secretary;
                    ``(B) a revocation of the organic certification of
                a producer or handler; or
                    ``(C) a revocation of the accreditation of a
                certifying agent; or
            ``(3) to sell, or attempt to sell, a product that is
        represented as being organically produced in accordance with
        this title if in fact the product has not been produced or
        handled in accordance with this title.
    ``(e) Enforcement.--
            ``(1) Order.--The Secretary may issue an order to stop the
        sale of an agricultural product that is labeled or otherwise
        represented as being organically produced--
                    ``(A) only upon the reasonable belief by the
                Secretary, supported by substantial evidence, that such
                agricultural product does not meet the national and
                State standards for organic production and handling
                provided in sections 2105 through 2114 and section
                2118, until the product can be verified--
                            ``(i) as meeting the national and State
                        standards for organic production and handling
                        as provided in sections 2105 through 2114;
                            ``(ii) as having been produced or handled
                        without the use of a prohibited substance
                        listed under section 2118; and
                            ``(iii) as being produced and handled by a
                        certified organic operation; and
                    ``(B) if a person has committed an unlawful act
                with respect to the product under subsection (d).
            ``(2) Revocation of certification or accreditation.--After
        notice and opportunity for an administrative appeal under
        section 2121, if the Secretary determines a producer, a
        handler, or a certifying agent committed a violation of this
        title that is an unlawful act under subsection (d), the
        Secretary may revoke the organic certification of such producer
        or such handler, or the accreditation of such certifying agent.
            ``(3) Violation of order or revocation.--A person who
        violates an order to stop the sale of a product as an
        organically produced product under paragraph (1), or a
        revocation of certification or accreditation under paragraph
        (2), shall be subject to 1 or more of the penalties provided in
        subsections (a) and (b) of section 2120.
    ``(f) Appeal.--
            ``(1) In general.--An order under subsection (e)(1), or a
        revocation of certification or accreditation under subsection
        (e)(2)(B), shall be final and conclusive unless the affected
        person files an appeal of the order--
                    ``(A) first, to the administrative appeals process
                established under section 2121(a); and
                    ``(B) after a final decision of the Secretary under
                the process referred to in subparagraph (A), if the
                affected person so elects, to a United States district
                court as provided in section 2121(b) not later than 30
                days after the date of the final decision.
            ``(2) Standard.--An order under subsection (e)(1), or a
        revocation of certification or accreditation under subsection
        (e)(2)(B), shall be set aside only if the order, or the
        revocation of certification or accreditation, is not supported
        by substantial evidence.
    ``(g) Noncompliance.--
            ``(1) In general.--If a person covered by this title fails
        to obey an order, or a revocation of certification or
        accreditation, described in subsection (f)(2) after the order
        or revocation has become final and conclusive or after the
        appropriate United States district court has entered a final
        judgment in favor of the Secretary, the United States may apply
        to the appropriate United States district court for enforcement
        of the order, or the revocation of certification or
        accreditation.
            ``(2) Enforcement.--If the court determines that the order
        or revocation was lawfully made and duly served and that the
        person violated the order or revocation, the court shall
        enforce the order or revocation.
            ``(3) Civil penalty.--If the court finds that the person
        violated the order or revocation, the person shall be subject
        to a civil penalty of not more than $10,000 for each
        offense.''.

Output:
Amends the Organic Foods Production Act of 1990 to require all persons, including producers, handlers, and certifying agents, required to report information to the Secretary of Agriculture (USDA) under such Act to maintain all contracts, agreements, receipts, and other records associated with the organic certification program for 5 years (10 years for a certifying agent).

	Authorizes investigative and enforcement actions for violations of such Act.


Input:
SECTION 1. MEDICARE DEMONSTRATION PROGRAM ON THE USE OF THIRD-PARTY
              INTEREST-FREE PAYMENT ARRANGEMENTS TO REDUCE MEDICARE
              HOSPITAL PART A BAD DEBT CLAIMS.

    (a) In General.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall establish a 3-year
demonstration program (in this section referred to as the
``demonstration program'') in 5 States to determine the impact on
patient engagement and satisfaction, health outcomes, and claims for
Medicare hospital part A bad debt (as defined in subsection (d)(2)) of
hospitals' implementing third-party interest-free payment arrangements
(as defined in subsection (b)).
    (b) Third-Party Interest-Free Payment Arrangement Defined.--In this
section, the term ``third-party interest-free payment arrangement''
means, with respect to a hospital and individuals who are receiving
inpatient hospital services for which payment may be made under part A
of title XVIII of the Social Security Act, an arrangement between the
hospital, a third-party, and such individuals under which--
            (1) the hospital offers to all such individuals the option
        of making payment of Medicare part A cost-sharing under such an
        arrangement for such services rather than through the routine
        billing process for such cost-sharing;
            (2) in the case of any such individual who agrees to such
        offer, the hospital assigns to the third party the rights of
        collection for such Medicare part A cost-sharing from such
        individual and efforts for such collection by the third party
        pursuant to this section shall be treated as reasonable
        collection efforts by the hospital for purposes of section
        413.89(e) of title 42 of the Code of Federal Regulations (or
        any successor regulation);
            (3) in the case of any such individual who does not agree
        to such offer, the hospital payment of Medicare part A cost-
        sharing for such services shall continue to be made through the
        routine billing process for such cost-sharing (including with
        respect to claims for Medicare hospital part A bad debt); and
            (4) the third party--
                    (A) participates in a level of financial engagement
                and education with all such individuals who agree to
                such offer to ensure such individuals are able to
                afford such cost-sharing payments;
                    (B) in collecting the amounts so owed, permits all
                such individuals who agree to such offer to make
                payment over time through a payment plan that does not
                charge interest with respect to the balance of the
                amount so owed; and
                    (C) pays the hospital the amount so collected under
                the arrangement less a fee that does not exceed 15
                percent of the amount so collected.
    (c) Payment Incentive.--The demonstration program shall provide
that a hospital that participates in such a third-party interest free
payment arrangement under the program and demonstrates improved patient
engagement and satisfaction, improved health outcomes, and a reduction
in the number of claims for Medicare hospital part A bad debt that are
reported to the Secretary is paid an amount equal to 10 percent of the
original amount owed in Medicare part A cost-sharing that is collected
under the arrangement. Such amount shall be paid from funds
appropriated (under subsection (f)(1) of section 1115A of the Social
Security Act (42 U.S.C. 1315a)) for activities to carry out such
section.
    (d) Report to Congress.--After the completion of the demonstration
program, the Secretary shall submit a report on the demonstration
program to the Committee on Ways and Means of the House of
Representatives and the Committee on Finance of the Senate. The report
shall include an analysis of whether the demonstration program reduced
the number and amount of Medicare hospital part A bad debt claims and
if there were improved health outcomes for Medicare beneficiaries who
did not forgo medical care due to their inability to pay for Medicare
part A cost-sharing.
    (e) Other Definitions.--In this section:
            (1) Medicare part a cost-sharing.--The term ``Medicare part
        A cost-sharing'' means, with respect to a hospital, amounts
        owed to the hospital that are derived from deductibles and
        coinsurance imposed under part A of title XVIII of the Social
        Security Act (42 U.S.C. 1395c et seq.).
            (2) Medicare hospital part a bad debt.--The term ``Medicare
        hospital part A bad debt'' means bad debt of a hospital that is
        attributable to the inability of the hospital to collect
        Medicare part A cost-sharing, taking into account collections
        made under third-party interest-free payment arrangements made
        under the demonstration program.

Output: This bill requires the Centers for Medicare & Medicaid Services (CMS) to establish a three-year demonstration program to determine the impact of third-party, interest-free payment arrangements on: (1) health outcomes, (2) patient engagement and satisfaction, and (3) claims for bad debt that are attributable to a hospital's inability to collect deductibles and coinsurance for Medicare hospital services. Under the program, the CMS shall provide a payment incentive to a hospital that participates in such a payment arrangement and demonstrates improvement in those three areas.


Input:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Asthma Awareness, Education and
Treatment Act of 1999''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) Asthma is a chronic lung condition that affects an
        estimated 14,600,000 Americans, including 4,800,000 children.
            (2) An estimated 40,000,000 to 50,000,000 Americans suffer
        from allergies, including allergic asthma.
            (3) Asthma is the most common chronic respiratory disease
        of children, accounting for 25 percent of school absenteeism,
        and is the third leading cause of preventable hospitalizations.
            (4) During the period 1980 through 1994 the prevalence of
        pediatric asthma increased by 72 percent, and the percentage of
        preschool children with asthma increased by 160 percent.
            (5) The prevalence of asthma is greater in women than in
        men (5.6 percent of women as compared to 5.1 percent of men).
            (6) The prevalence of asthma is greater in low-income
        families. In families with an annual income of less than
        $10,000, 79.2 of 1,000 individuals who are under the age of 45
        have asthma, while in families with an annual income of between
        $20,000 and $35,000, 53.6 of 1,000 individuals under the age of
        45 have asthma.
            (7) In 1997, more than 5,000 Americans died from asthma
        attacks. During the period 1993 through 1995, the average
        number of deaths from asthma for African Americans was 38.5
        deaths per million individuals, while the average for
        Caucasians was 15.1 deaths per million.
            (8) Asthma is estimated to cost the United States over
        $12,000,000,000 annually and the rise in the prevalence of
        asthma will lead to higher costs in the future.
            (9) African Americans are five times more likely than other
        segments of the population to seek care for asthma at an
        emergency room.
            (10) The asthma death rate is four times higher among
        African American children and two times higher among all
        African Americans.
            (11) Exercise improves the physical and psychological well-
        being of children, including improving self-esteem, and it can
        help children manage their asthma and form life-long habits of
        physical activity that can improve the quality of life and the
        length of life of the individual.

SEC. 3. GRANTS FOR PROJECTS FOR ASTHMA-RELATED ACTIVITIES FOR LOW-
              INCOME COMMUNITIES.

    (a) In General.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') may make grants to
public and nonprofit private entities for the purpose of carrying out
projects to provide for individuals in low-income communities--
            (1) screenings and referrals regarding asthma, allergies,
        and related respiratory problems in accordance with subsection
        (b);
            (2) information and education regarding such conditions in
        accordance with subsection (c); and
            (3) workshops regarding such conditions that are provided
        for parents, teachers, physical education instructors, school
        nurses, school counselors, athletic coaches, and other
        individuals who serve in supervisory roles of children in such
        communities.
    (b) Screenings and Referrals.--The Secretary shall ensure that
screenings and referrals regarding asthma, allergies, and related
respiratory problems under subsection (a) are comprehensive, and that
the settings in which the screenings and referrals are provided
include--
            (1) traditional medical settings such as hospitals, health
        clinics, and the offices of physicians; and
            (2) nontraditional settings for the provision of such
        services, such as nurseries, elementary and secondary schools,
        community centers, public housing units, volunteer
        organizations, convenience stores, local governmental offices,
        day care centers, sites that offer nutrition-related services
        for women, infants, and children, and governmental offices that
        provide cash assistance for low-income individuals.
    (c) Information and Education.--The Secretary shall ensure that
information and education on asthma, allergies, and related respiratory
problems under subsection (a) is provided in accordance with the
following:
            (1) The information and education is provided in the
        language and cultural context that is most appropriate for the
        individuals for whom the information and education is intended.
            (2) The information and education includes information and
        education to increase understanding on the following:
                    (A) The symptoms of the conditions.
                    (B) Preventing the conditions.
                    (C) Monitoring and managing the conditions,
                including--
                            (i) avoiding circumstances that may cause
                        asthma attacks or other respiratory problems;
                        and
                            (ii) being aware of appropriate medication
                        options, such as the need as appropriate to
                        keep in one's possession an asthma inhaler.
                    (D) The importance for asthmatic children of
                regularly engaging in physical activities.
            (3) The settings in which the information and education are
        provided include traditional settings such as the settings
        described in subsection (b)(1) and nontraditional settings such
        as the settings described in subsection (b)(2).
    (d) Evaluations of Projects.--The Secretary shall (directly or
through contract) provide for the evaluation of projects carried under
subsection (a), including--
            (1) determining the number of children who have received
        screenings and referrals through the projects;
            (2) determining the extent to which the projects have had
        an effect on the manner in which individuals served by the
        projects prevent and manage asthma, allergies, and related
        respiratory problems; and
            (3) evaluating the effectiveness of materials used in
        providing information and education.
    (e) Inclusion in Project of Local Community-Based Organization.--A
condition for the receipt of a grant under subsection (a) is that--
            (1) the applicant for the grant be a community-based
        organization that provides services in the low-income community
        in which the project under such subsection is to be carried
        out; or
            (2) the applicant for the grant demonstrate to the
        Secretary that one or more representatives from such an
        organization will play a substantial role in carrying out the
        project.
    (f) Application for Grant.--The Secretary may make a grant under
subsection (a) only if an application for the grant is submitted to the
Secretary and the application is in such form, is made in such manner,
and contains such agreements, assurances, and information as the
Secretary determines to be necessary to carry out this section
    (g) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $8,000,000
for fiscal year 2000, and such sums as may be necessary for each of the
fiscal years 2001 through 2004.

SEC. 4. NATIONAL MEDIA CAMPAIGN TO PROVIDE ASTHMA-RELATED INFORMATION.

    (a) In General.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') may make awards of
contracts to provide for a national media campaign to provide to the
public and health care providers information on asthma, allergies, and
related respiratory problems, with priority given to the occurrence of
such conditions in children.
    (b) Certain Requirements.--The Secretary shall ensure that the
national media campaign under subsection (a) is carried out in
accordance with the following:
            (1) The campaign provides information regarding the
        prevention and management of asthma, allergies, and related
        respiratory problems.
            (2) With respect to a community in which the campaign is
        carried out--
                    (A) the campaign provides information regarding the
                availability in the community of programs that provide
                screenings, referrals, and treatment regarding such
                conditions and training in managing the conditions; and
                    (B) the campaign is carried out in the language and
                cultural context that is most appropriate for the
                individuals for whom the campaign is intended.
    (c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $600,000 for
fiscal year 2000, and such sums as may be necessary for each of the
fiscal years 2001 through 2004.

SEC. 5. TAX CREDIT FOR DONATIONS OF PEST CONTROL AND CLIMATE CONTROL
              SERVICES.

    (a) In General.--Subpart D of part IV of subchapter A of chapter 1
of the Internal Revenue Code of 1986 (relating to business related
credits) is amended by adding at the end the following new section:

``SEC. 45D. CREDIT FOR DONATIONS OF PEST CONTROL AND CLIMATE CONTROL
              SERVICES.

    ``(a) In General.--For purposes of section 38, in the case of a
taxpayer engaged in the trade or business of providing pest control or
climate control services, the donation credit determined under this
section for the taxable year is an amount equal to 10 percent of the
aggregate cost (including wages) paid or incurred by the taxpayer
during the taxable year in providing qualified pest control and climate
control services.
    ``(b) Qualified Pest Control and Climate Control Services.--For
purposes of this section--
            ``(1) In general.--The term `qualified pest control and
        climate control services' means pest control and climate
        control services provided without charge in--
                    ``(A) any public housing (as defined in section
                3(b) of the United States Housing Act of 1937), or
                    ``(B) any multifamily residential rental property
                if it is reasonably expected that at least 75 percent
                of the occupants of the dwelling units have incomes
                below 200 percent of the official poverty line,
        but only if such services are part of a good faith effort
        (including follow-up treatments) to accomplish the intended
        result and are verified in such manner as the Secretary shall
        prescribe.
            ``(2) Pest control and climate control services.--For
        purposes of paragraph (1), the term `pest control and climate
        control services' means services--
                    ``(A) to eliminate cockroaches, dust mites, animal
                dander, and mold, or
                    ``(B) to improve poor ventilation and lack of
                temperature control.''.
    (b) Conforming Amendments.--
            (1) Section 38(b) of such Code is amended--
                    (A) by striking ``plus'' at the end of paragraph
                (11),
                    (B) by striking the period at the end of paragraph
                (12), and inserting a comma and ``plus'', and
                    (C) by adding at the end the following new
                paragraph:
            ``(13) in the case of a taxpayer engaged in the trade or
        business of providing pest control or climate control services
        (as defined in section 45D(b)(2)), the donation credit
        determined under section 45D.''.
            (2) Subsection (d) of section 39 of such Code (relating to
        carryback and carryforward of unused credits) is amended by
        adding at the end the following new paragraph:
            ``(9) No carryback of section 45d credit before january 1,
        2000.--No portion of the unused business credit for any taxable
        year which is attributable to the credit determined under
        section 45D may be carried back to a taxable year beginning
        before January 1, 2000.''.
            (3) The table of sections for subpart D of part IV of
        subchapter A of chapter 1 of such Code is amended by adding at
        the end the following new item:

                              ``Sec. 45D. Credit for donations of pest
                                        control and climate control
                                        services.''.
    (c) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 1999.

SEC. 6. RESEARCH ON RELATIONSHIP BETWEEN AIR POLLUTANTS AND ASTHMA-
              RELATED PROBLEMS.

    (a) In General.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary''), in consultation with
the Administrator of the Environmental Protection Agency, shall
(directly or through grants and contracts) provide for the conduct of
research for the purpose of determining whether and to what extent
there is a causal relationship between air pollutants and the
occurrence of asthma, allergies, and related respiratory problems.
    (b) Requirement Regarding Clinical Participants.--
            (1) In general.--In providing for the conduct of clinical
        research under subsection (a), the Secretary shall give
        priority to providing to individuals described in paragraph (2)
        opportunities to undergo clinical evaluations for purposes of
        the research.
            (2) Relevant populations.--For purposes of paragraph (1),
        the individuals referred to in this paragraph are individuals
        who are residents of communities in which the average family
        income is at or below 200 percent of the official poverty line,
        as established by the Director of the Office of Management and
        Budget and revised by the Secretary in accordance with section
        673(2) of the Omnibus Budget Reconciliation Act of 1981.

SEC. 7. COORDINATION OF FEDERAL ACTIVITIES TO ADDRESS ASTHMA-RELATED
              HEALTH CARE NEEDS.

    (a) In General.--The Director of the National Heart, Lung, and
Blood Institute shall, through the National Asthma Education Prevention
Program Coordinating Committee--
            (1) identify all Federal programs that carry out asthma-
        related activities;
            (2) develop, in consultation with appropriate Federal
        agencies and professional and voluntary health organizations, a
        Federal plan for responding to asthma; and
            (3) not later than 12 months after the date of enactment of
        this Act, submit recommendations to the Congress on ways to
        strengthen and improve the coordination of asthma-related
        activities of the Federal Government.
    (b) Representation of the Department of Housing and Urban
Development.--A representative of the Department of Housing and Urban
Development shall be included on the National Asthma Education
Prevention Program Coordinating Committee for the purpose of performing
the tasks described in subsection (a).
    (c) Authorization of Appropriations.--Out of any funds otherwise
appropriated for the National Institutes of Health, $5,000,000 shall be
made available to the National Asthma Education Prevention Program for
the period of fiscal years 2000 through 2004 for the purpose of
carrying out this section. Funds made available under this subsection
shall be in addition to any other funds appropriated to the National
Asthma Education Prevention Program for any fiscal year during such
period.

SEC. 8. COMPILATION OF DATA BY CENTERS FOR DISEASE CONTROL AND
              PREVENTION.

    The Director of the Centers for Disease Control and Prevention, in
consultation with the National Asthma Education Prevention Program
Coordinating Committee, shall--
            (1) conduct local asthma surveillance activities to collect
        data on the prevalence and severity of asthma and the quality
        of asthma management, including--
                    (A) telephone surveys to collect sample household
                data on the local burden of asthma; and
                    (B) health care facility specific surveillance to
                collect asthma data on the prevalence and severity of
                asthma, and on the quality of asthma care; and
            (2) compile and annually publish data on--
                    (A) the prevalence of children suffering from
                asthma in each State; and
                    (B) the childhood mortality rate associated with
                asthma nationally and in each State.

Output:
Asthma Awareness, Education and Treatment Act of 1999 - Authorizes the Secretary of Health and Human Services to make grants to public and nonprofit private entities for carrying out projects to provide for individuals in low-income communities: (1) screenings and referrals regarding asthma, allergies, and related respiratory problems; (2) information and education regarding such conditions; and (3) workshops regarding such conditions for specified individuals who serve in supervisory roles of children in such communities.  Outlines requirements for such projects.  Authorizes appropriations for FY 2000 through 2004.
Authorizes the Secretary to award contracts for a national media campaign to provide to the public and health care providers information on such conditions, with priority given to the occurrence of such conditions in children.  Authorizes appropriations.
Amends the Internal Revenue Code to provide a tax credit, effective as of January 1, 2000, to providers of pest control or climate control services who donate such services in any public housing or low-income multifamily residential rental property.
Directs the Secretary to conduct research to determine whether and to what extent there is a causal relationship between air pollutants and the occurrence of such conditions, requiring priority to be given to clinical evaluations of low-income individuals.
Requires the Director of the National Heart, Blood, and Lung Institute to: (1) identify all Federal programs that carry out asthma-related activities; (2) develop a Federal plan for responding to asthma; and (3) submit recommendations to Congress on strengthening the coordination of Federal asthma-related activities.  Authorizes appropriations.
Requires the Director of the Centers for Disease Control and Prevention to: (1) conduct local asthma surveillance activities in order to collect asthma prevalence, severity, and management data; and (2) compile and annually publish data on the prevalence of children suffering from asthma in each State, as well as the childhood asthma mortality rate nationally and in each State.


Input:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Enterprise Capital Formation Act of
1995''.

SEC. 2. FINDINGS.

    The Congress hereby finds that--
            (1) investments in small business venture capital stock
        should be encouraged because of both the special risks and the
        social and economic benefits associated with such investments,
            (2) the exclusion from income of gain on small business
        venture capital stock is an important incentive for individuals
        and corporations to invest in such stock, and
            (3) tax incentives for investments in capital assets in
        general should be supplemented with an effective tax incentive
        for investments in small business venture capital stock.

SEC. 3. MODIFICATIONS TO EXCLUSION OF GAIN ON CERTAIN SMALL BUSINESS
              STOCK.

    (a) Increase in Exclusion.--Subsection (a) of section 1202 of the
Internal Revenue Code of 1986 is amended by striking ``50 percent'' and
inserting ``75 percent''.
    (b) Exclusion Available to Corporations.--
            (1) In general.--Subsection (a) of section 1202 of such
        Code is amended by striking ``other than a corporation''.
            (2) Technical amendment.--Subsection (c) of section 1202 of
        such Code is amended by adding at the end the following new
        paragraph:
            ``(4) Stock held among members of controlled group not
        eligible.--Stock of a member of a parent-subsidiary controlled
        group (as defined in subsection (d)(3)) shall not be treated as
        qualified small business stock while held by another member of
        such group.''
    (c) Repeal of Minimum Tax Preference.--
            (1) In general.--Subsection (a) of section 57 of such Code
        is amended by striking paragraph (7).
            (2) Technical amendment.--Subclause (II) of section
        53(d)(1)(B)(ii) of such Code is amended by striking ``, (5),
        and (7)'' and inserting ``and (5)''.
    (d) Stock of Larger Businesses Eligible for Exclusion.--
            (1) Paragraph (1) of section 1202(d) of such Code is
        amended by striking ``$50,000,000'' each place it appears and
        inserting ``$100,000,000''.
            (2) Subsection (d) of section 1202 of such Code is amended
        by adding at the end the following new paragraph:
            ``(4) Inflation adjustment of asset limitation.--In the
        case of stock issued in any calendar year after 1996, the
        $100,000,000 amount contained in paragraph (1) shall be
        increased by an amount equal to--
                    ``(A) such dollar amount, multiplied by
                    ``(B) the cost-of-living adjustment determined
                under section 1(f)(3) for the calendar
                 year in which the taxable year begins, determined by
substituting `calendar year 1995' for `calendar year 1992' in
subparagraph (B) thereof.
        If any amount as adjusted under the preceding sentence is not a
        multiple of $10,000, such amount shall be rounded to the
        nearest multiple of $10,000.''
    (e) Repeal of Per-Issuer Limitation.--Section 1202 of such Code is
amended by striking subsection (b).
    (f) Other Modifications.--
            (1) Repeal of working capital limitation.--Paragraph (6) of
        section 1202(e) of such Code is amended--
                    (A) by striking ``within 2 years'' in subparagraph
                (B), and
                    (B) by striking the last sentence.
            (2) Exception from redemption rules where business
        purpose.--Paragraph (3) of section 1202(c) of such Code is
        amended by adding at the end the following new subparagraph:
                    ``(D) Waiver where business purpose.--A purchase of
                stock by the issuing corporation shall be disregarded
                for purposes of subparagraphs (A) and (B) if the
                issuing corporation establishes that there was a
                business purpose for such purchase and such purchase is
                not inconsistent with the purposes of this section.''
    (g) Effective Date.--The amendments made by this section shall
apply to stock issued after December 31, 1994.
    (h) Election To Apply Amendments to Stock Issued After August 10,
1993.--
            (1) In general.--The amendments made by this section shall
        apply to any qualified stock issued after August 10, 1993, if
        the taxpayer elects to apply such amendments with respect to
        such stock.
            (2) Qualified stock.--For purposes of paragraph (1), the
        term ``qualified stock'' means stock--
                    (A) which is held by the taxpayer on December 31,
                1994, and
                    (B) which was not qualified small business stock
                (as defined section 1202(c) of the Internal Revenue
                Code of 1986) when issued but which would be qualified
                small business stock (as so defined) if the amendments
                made by this section applied to stock issued after
                August 10, 1993.
            (3) Recognition of gain.--For purposes of the Internal
        Revenue Code of 1986--
                    (A) In general.--Any qualified stock to which the
                election under paragraph (1) applies shall be treated--
                            (i) as having been sold on January 1, 1995,
                        for an amount equal to its fair market value on
                        such date, and
                            (ii) as having been reacquired on such date
                        for an amount equal to such fair market value.
                The preceding sentence shall not apply for purposes of
                determining whether the stock is qualified small
                business stock (as so defined).
                    (B) Treatment of gain or loss.--
                            (i) Any gain resulting from subparagraph
                        (A) shall be treated as received or accrued on
                        January 1, 1995, and shall be recognized
                        notwithstanding any provision of the Internal
                        Revenue Code of 1986.
                            (ii) Any loss resulting from subparagraph
                        (A) shall not be allowed for any taxable year.
            (4) Election.--An election under paragraph (1) shall be
        made in such manner as the Secretary may prescribe and shall
        specify the stock for which such election is made. Such an
        election, once made with respect to any stock, shall be
        irrevocable.

Output: Enterprise Capital Formation Act of 1995 - Amends the Internal Revenue Code to allow an exclusion of 75 percent (currently, 50 percent) of the gain from the sale or exchange of qualified small business stock held more than five years.  Removes provisions restricting that exclusion to noncorporate taxpayers.  Prohibits treating stock of a member of a parent-subsidiary controlled group as qualified while held by another member of such group.  Removes provisions listing the excluded amounts as items of tax preference for purposes of alternative minimum tax.  Changes the requirements for a business to qualify as a small business for these purposes.  Removes provisions relating to a per-issuer limitation on a taxpayer's eligible gain.  Modifies the working capital requirements of the active business requirement.  Applies the amendments made by this Act to any qualified stock issued after August 10, 1993, if the taxpayer so elects.


Input:
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Pipeline Safety
and Community Empowerment Act of 2010''.
    (b) Table of Contents.--

Sec. 1. Short title; table of contents.
Sec. 2. References to title 49, United States Code.
Sec. 3. Notice to property owners and residents.
Sec. 4. Facility operation information standards.
Sec. 5. Required periodic inspection of pipelines by instrumented
                            internal inspection devices.
Sec. 6. Automatic or remote shut off valves.
Sec. 7. Availability of industry standards and procedures adopted in
                            regulations by reference.
Sec. 8. Leak detection.
Sec. 9. Considerations for identification of high consequence areas.
Sec. 10. Public education programs.

SEC. 2. REFERENCES TO TITLE 49, UNITED STATES CODE.

    Except as otherwise expressly provided, whenever in this Act an
amendment or repeal is expressed in terms of an amendment to, or a
repeal of, a section or other provision, the reference shall be
considered to be made to a section or other provision of title 49,
United States Code.

SEC. 3. NOTICE TO PROPERTY OWNERS AND RESIDENTS.

    Section 60102(c)(4) is amended by adding at the end the following:
            ``(C) Notice to property owners and residents.--
                    ``(i) In general.--Not later than one year after
                the date of enactment of this subparagraph, the
                Secretary shall prescribe minimum standards to require
                the owner or operator of a pipeline facility to notify
                all owners and residents of property located within
                2,000 feet of a transmission line of the facility of--
                            ``(I) the proximity of the property to the
                        transmission line; and
                            ``(II) in the case of a transmission line
                        located on private residential property, the
                        specific location of the line on the property.
                    ``(ii) Required information.--The notice under
                clause (i) shall include, at a minimum--
                            ``(I) a method for electronic access to the
                        information described in clause (i) through an
                        Internet Web site and toll free telephone
                        number;
                            ``(II) information on how to obtain a map
                        of the pipeline system through the National
                        Pipeline Mapping System; and
                            ``(III) such other information as the
                        Secretary considers appropriate.
                    ``(iii) Deadlines.--The notice under clause (i)
                shall be provided not later than 2 years after the date
                of enactment of this subparagraph and at least once
                every 3 years thereafter.''.

SEC. 4. FACILITY OPERATION INFORMATION STANDARDS.

    Section 60102(d) is amended by striking the first sentence and
inserting the following: ``Not later than one year after the date of
enactment of the Pipeline Safety and Community Empowerment Act of 2010,
the Secretary shall prescribe minimum standards under this section
requiring an operator of a pipeline facility subject to this chapter to
maintain information related to operating the facility as required by
the standards prescribed under this chapter and to provide that
information, including any updates and changes, to the Secretary, State
regulatory officials, State and local emergency responders, and such
other entities as the Secretary considers appropriate (except that in
the case of a local emergency responder the Secretary shall provide the
information described in paragraphs (1), (2), (5), and (6) only to the
extent applicable to the local district). The Secretary shall keep on
file the information submitted to the Secretary under the preceding
sentence.''.

SEC. 5. REQUIRED PERIODIC INSPECTION OF PIPELINES BY INSTRUMENTED
              INTERNAL INSPECTION DEVICES.

    Section 60102(f)(2) is amended to read as follows:
            ``(2) Periodic inspections.--
                    ``(A) In general.--Not later than 270 days after
                the date of enactment of the Pipeline Safety and
                Community Empowerment Act of 2010, the Secretary shall
                prescribe additional standards requiring the periodic
                inspection of each pipeline the operator of the
                pipeline identifies under section 60109.
                    ``(B) Inspection with internal inspection device.--
                            ``(i) In general.--Except as provided in
                        clause (ii), the standards prescribed under
                        subparagraph (A) shall require that an
                        inspection be conducted at least once every 5
                        years with an instrumented internal inspection
                        device.
                            ``(ii) Exception for segments where devices
                        cannot be used.--If a device described in
                        clause (i) cannot be used in a segment of a
                        pipeline, the standards prescribed in
                        subparagraph (A) shall require use of an
                        inspection method that the Secretary certifies
                        to be at least as effective as using the device
                        in--
                                    ``(I) detecting corrosion;
                                    ``(II) detecting pipe stress; and
                                    ``(III) otherwise providing for the
                                safety of the pipeline.
                    ``(C) Operation under high pressure.--The Secretary
                shall prohibit a pipeline segment from operating under
                high pressure if the pipeline segment cannot be
                inspected--
                            ``(i) with a device described in
                        subparagraph (B)(i) in accordance with the
                        standards prescribed pursuant to such
                        subparagraph; or
                            ``(ii) using an inspection method described
                        in subparagraph (B)(ii) in accordance with the
                        standards prescribed pursuant to such
                        subparagraph.''.

SEC. 6. AUTOMATIC OR REMOTE SHUT OFF VALVES.

    Section 60102(j) is amended by adding at the end the following:
    ``(4) Automatic or Remote Shut Off Valves.--
            ``(A) Minimum standards.--Not later than one year after the
        date of enactment of this paragraph, the Secretary shall
        prescribe minimum standards to require an owner or operator of
        a covered pipeline facility to install and use automatic or
        remote shut off valves to reduce risks in the event of a
        rupture.
            ``(B) Applicability of minimum standards.--
                    ``(i) New facilities.--The minimum standards shall
                apply to a covered pipeline facility that is newly
                constructed or entirely replaced after the date of
                issuance of the standards.
                    ``(ii) Existing facilities.--
                            ``(I) Facilities located near earthquake
                        faults.--The minimum standards shall apply to a
                        covered pipeline facility that exists as of the
                        date of issuance of the standards and is
                        located within 10 miles of a significant
                        earthquake fault beginning on the earliest date
                        that the Secretary determines is technically
                        feasible and not later than 2 years after the
                        date of issuance of the standards.
                            ``(II) Other facilities.--The minimum
                        standards shall apply to a covered pipeline
                        facility that exists as of the date of issuance
                        of the standards (other than a facility
                        described in subclause (I)) not later than 5
                        years after the date of issuance of the
                        standards.
            ``(C) Definitions.--In this paragraph, the following
        definitions apply:
                    ``(i) Covered pipeline facility.--The term `covered
                pipeline facility' means a pipeline facility that is
                located in a Class 3 or 4 location, as described in
                section 192.5 of title 49, Code of Federal Regulations,
                as in effect on the date of enactment of the Pipeline
                Safety and Community Empowerment Act of 2010.
                    ``(ii) Significant earthquake fault.--The term
                `significant earthquake fault' means an earthquake
                fault for which there is a 1 in 10 chance or greater of
                a magnitude 6.7 or greater earthquake in the next 50
                years, as determined by the Secretary based on
                information compiled by the United States Geological
                Survey.''.

SEC. 7. AVAILABILITY OF INDUSTRY STANDARDS AND PROCEDURES ADOPTED IN
              REGULATIONS BY REFERENCE.

    Section 60102 is amended by adding at the end the following:
    ``(n) Availability of Industry Standards and Procedures Adopted in
Regulations by Reference.--The Secretary shall ensure that industry
standards and procedures adopted by reference as part of the Federal
pipeline safety regulatory program under this chapter are easily
available to the public free of charge. This subsection shall apply to
regulations issued before, on, or after the date of enactment of this
subsection.''.

SEC. 8. LEAK DETECTION.

    Section 60102 (as amended by section 7 of this Act) is further
amended by adding at the end the following:
    ``(o) Leak Detection.--
            ``(1) In general.--An owner or operator of a pipeline
        facility shall ensure that the facility is equipped with a leak
        detection system capable of promptly detecting a leak.
            ``(2) Performance standards.--Not later than 18 months
        after the date of enactment of this subsection, the Secretary
        shall issue a final rule establishing performance standards for
        such leak detection systems. In establishing the performance
        standards, the Secretary shall consider, at a minimum,
        requiring--
                    ``(A) hazardous liquid pipeline facilities to have
                the continuous capability to detect a daily discharge
                equal to not more than one percent of daily throughput;
                    ``(B) natural gas transmission pipeline facilities
                to provide for flow verification through an accounting
                method such as volume balance and rate of pressure at
                least once every 24 hours;
                    ``(C) in the case of a remote pipeline, increased
                aerial surveillance of the pipeline; and
                    ``(D) owners and operators of pipeline facilities
                to meet other requirements as the Secretary determines
                necessary and practicable to enhance the ability of
                such owners and operators to promptly detect a leak.''.

SEC. 9. CONSIDERATIONS FOR IDENTIFICATION OF HIGH CONSEQUENCE AREAS.

    Section 60109 is amended by adding at the end the following:
    ``(g) Considerations for Identification of High Consequence
Areas.--In identifying high consequence areas under this section, the
Secretary shall consider--
            ``(1) the seismicity of the area;
            ``(2) the age of the pipe; and
            ``(3) whether the pipe at issue can be inspected using the
        most modern instrumented internal inspection devices.''.

SEC. 10. PUBLIC EDUCATION PROGRAMS.

    Section 60116 is amended by adding at the end the following:
    ``(d) Approval Process.--
            ``(1) In general.--The Secretary shall approve or
        disapprove a public education program submitted to the
        Secretary by the owner or operator of a pipeline facility under
        subsection (b).
            ``(2) Context of review.--The Secretary may conduct the
        approval process under paragraph (1) as an element of the
        Secretary's inspection of an owner or operator.
            ``(3) Inadequate programs.--If the Secretary determines
        that a public education program does not comply with the
        requirements of this section or regulations issued under this
        section or has not been adequately implemented, the Secretary
        may conduct proceedings under this chapter.
    ``(e) Effectiveness of Public Education Programs.--
            ``(1) Assessment.--The Comptroller General shall conduct an
        assessment of the effectiveness of the public education
        programs carried out under this section.
            ``(2) Report to congress.--Not later than one year after
        the date of enactment of this subsection, the Comptroller
        General shall submit to Congress a report on the results of the
        assessment.''.

Output:
Pipeline Safety and Community Empowerment Act of 2010 - Directs the Secretary of Transportation (DOT) to prescribe minimum standards to require: (1) a pipeline facility owner or operator to notify all property owners and residents located within 2,000 feet of a pipeline transmission line of the property's proximity to the line, including its specific location if located on private residential property; and (2) the notice to include a method for electronic access to such information through the Internet and a toll free telephone number, as well as information on how to obtain a map of the pipeline system through the National Pipeline Mapping System.

Revises requirements for minimum standards for information a pipeline operator must maintain about a pipeline facility. Directs the Secretary to prescribe such standards requiring an operator to provide that information (including updates and changes), not only to the Secretary (as under current law), but also to state regulatory officials, state and local emergency responders, and other appropriate entities.

Revises requirements for additional standards for periodic inspection of pipeline facilities in high-density population areas and environmentally sensitive areas. Directs the Secretary to prescribe standards requiring the mandatory periodic inspection of each pipeline facility with an instrumented internal inspection device ("smart pig") occur at least once every five years.

Allows the use of an inspection method, subject to certain requirements, that is not a "smart pig" for any pipeline segment incompatible with a "smart pig."

Requires the Secretary to prohibit a pipeline segment from operating under high pressure if that segment cannot be inspected: (1) with a "smart pig"; or (2) using an inspection method at least as effective as one.

Directs the Secretary to prescribe minimum standards to require a pipeline facility owner or operator to install automatic or remote shut off valves to reduce risks in the event of a rupture.

Requires a pipeline facility owner or operator to ensure that the pipeline facility is equipped with a leak detection system capable of promptly detecting a leak.

Directs the Secretary to approve or disapprove modified public education programs submitted by pipeline facility owners or operators. Requires the Comptroller General to assess and report to Congress on the effectiveness of such programs.


Input:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``National Center for Research on
Domestic Health Disparities Act''.

SEC. 2. FINDINGS.

    The Congress makes the following findings:
            (1) The United States ranks below most industrialized
        nations in health status measured by longevity, sickness, and
        mortality.
            (2) The United States ranks 24th among industrialized
        nations in infant mortality.
            (3) This poor rank in health status is attributed in large
        measure to the lower health status of America's minority
        populations.
            (4) Many minority groups suffer disproportionately from
        cancer. Disparities exist in both mortality and incidence
        rates. For men and women combined, African Americans have a
        cancer death rate about 35 percent higher than that for whites.
        Paralleling the death rate, the incidence rate for lung cancer
        in African American men is about 50 percent higher than white
        men. Native Hawaiian men also have elevated rates of lung
        cancer compared with white men. Alaska Native men and women
        suffer from higher rates of cancers of the colon and rectum
        than do whites. Vietnamese women in the United States have a
        cervical cancer incidence rate more than five times greater
        than white women. Hispanic women also suffer elevated rates of
        cervical cancer.
            (5) Infant death rates among African American, American
        Indians and Alaska Natives, and Hispanics were well above the
        national average. The greatest disparity exists for African
        Americans. The overall American Indian rate does not reflect
        the diversity among Indian communities, some of which have
        infant mortality rates approaching twice the national rate.
            (6) SIDS accounts for approximately 10 percent of all
        infant deaths in the first year of life. Minority populations
        are at greater risk for SIDS. In addition to the greater risks
        among African Americans, the rates are three to four times as
        high for some American Indians and Alaska Native populations.
            (7) Cardiovascular disease is the leading cause of death
        for all racial and ethnic groups. Major disparities exist among
        population groups, with a disproportionate burden of death and
        disability from cardiovascular disease in minority and low-
        income populations. Stroke is the only leading cause of death
        for which mortality is higher for Asian-American males than for
        white males.
            (8) Racial and ethnic minorities have higher rates of
        hypertension, tend to develop hypertension at an earlier age,
        and are less likely to undergo treatment to control their high
        blood pressure.
            (9) Diabetes, the seventh leading cause of death in the
        United States, is a serious public health problem affecting
        racial and ethnic communities. The prevalence of diabetes in
        African Americans is approximately 70 percent higher than
        whites and the prevalence in Hispanics is nearly double that of
        whites. The prevalence rate of diabetes among American Indians
        and Alaska Natives is more than twice that for the total
        population and at least one tribe, the Pimas of Arizona, have
        the highest known prevalence of diabetes of any population in
        the world.
            (10) The human immunodeficiency virus (``HIV''), which
        causes acquired immune deficiency syndrome (``AIDS''), results
        in disproportionate suffering in minority populations. Minority
        persons represent 25 percent of the total United States
        population, but 54 percent of all cases of AIDS.
            (11) More than 75 percent of AIDS cases reported among
        women and children occur in minority women and children.
            (12) Despite suffering disproportionate rates of illness,
        death, and disability, minorities have not been proportionately
        represented in many clinical research trials, except in studies
        of behavioral risk factors associated with negative
        stereotypes.
            (13) Culturally sensitive approaches to research are needed
        to encourage minority participation in research studies.
            (14) There is a national need for minority scientists in
        the field of biomedical, clinical, and health services
        research.
            (15) In 1990, only 3.3 percent of all United States medical
        school faculties were underrepresented minority persons.
            (16) Only 1 percent of full professors were
        underrepresented minority persons in 1990.
            (17) The proportion of underrepresented minorities in
        higher rank academic ranks, such as professors and associated
        professors, actually decreased from 1980 to 1990.

SEC. 3. ESTABLISHMENT OF NATIONAL CENTER FOR RESEARCH ON DOMESTIC
              HEALTH DISPARITIES.

    (a) In General.--Part E of title IV of the Public Health Service
Act (42 U.S.C. 287 et seq.), as amended by section 601 of the
Departments of Labor, Health and Human Services, and Education, and
Related Agencies Appropriations Act, 1999 (as contained in section
101(f) of Public Law 105-277) (112 Stat. 2681-387), is amended by
adding at the end the following subpart:

     ``Subpart 6--National Center for Research on Domestic Health
                              Disparities

    ``Sec. 485E. (a) In General.--The general purpose of the National
Center for Research on Domestic Health Disparities (in this subpart
referred to as the `Center') is the conduct and support of basic and
clinical research, training, the dissemination of health information,
and other programs with respect to minority health.
    ``(b) Coordination of Activities.--
            ``(1) In general.--The Director of the Center shall
        coordinate the activities of the Center with related activities
        of the other agencies of the National Institutes of Health,
        including the national research institutes.
            ``(2) Agencywide recommendations through comprehensive
        plan.--The Director of NIH, the Director of the Center, and the
        directors of the national research institutes shall collaborate
        for the purpose of developing, and periodically reviewing and
        as appropriate revising, a comprehensive plan that provides
        recommendations for the conduct and support by the National
        Institutes of Health of the activities described in subsection
        (a) with respect to minority health.
            ``(3) Certain activities.--For purposes of the
        comprehensive plan under paragraph (2), the Director of the
        Center shall--
                    ``(A) identify projects of research on minority
                health that should be conducted or supported by the
                Center and the other agencies of the National
                Institutes of Health, including the national research
                institutes;
                    ``(B) identify multidisciplinary research relating
                to research on minority health that should be so
                conducted or supported;
                    ``(C) promote coordination and collaboration among
                entities conducting research identified under
                subparagraph (A) or (B);
                    ``(D) encourage the conduct of such research by
                entities receiving funds from the national research
                institutes;
                    ``(E) recommend an agenda for conducting and
                supporting such research; and
                    ``(F) promote the sufficient allocation of the
                resources of the national research institutes for
                conducting and supporting such research.
    ``(c) Clinical Research Equity.--The Director of the Center shall
assist in the administration of section 492B with respect to the
inclusion of members of minority groups as subjects in clinical
research.
    ``(d) Research Endowments.--The Director of the Center may carry
out a program to facilitate research on minority health by providing
for research endowments at centers of excellence under section 736.
    ``(e) Advisory Council.--The Secretary shall, in accordance with
section 406, establish an advisory council to advise, assist, consult
with, and make recommendations to the Director of the Center on matters
relating to the activities described in subsection (a), and with
respect to such activities to carry out any other functions described
in section 406 for advisory councils under such section.
    ``(f) Biennial Report.--The Director of the Center shall prepare
biennial reports on the activities carried out or to be carried out by
the Center, and shall submit each such report to the Director of NIH
for inclusion in the biennial report under section 403.
    ``(g) Authorization of Appropriations.--For the purpose of carrying
out this subpart, there are authorized to be appropriated $100,000,000
for fiscal year 2000, and such sums as may be necessary for each of the
fiscal years 2001 through 2004. Such authorization of appropriations is
in addition to other authorizations of appropriations that are
available for the conduct and support of research on minority health by
the national research institutes and other agencies of the National
Institutes of Health.''.
    (b) Conforming Amendment.--Part A of title IV of the Public Health
Service Act (42 U.S.C. 281 et seq.) is amended by striking section 404.

SEC. 4. EFFECTIVE DATE.

    The amendments made by this Act take effect October 1, 1999, or
upon the date of the enactment of this Act, whichever occurs later.

Output:
National Center for Research on Domestic Health Disparities Act - Amends title IV (National Research Institutes) of the Public Health Service Act (PHSA), as amended by the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 1999, to establish, as another agency of the National Institutes of Health, a National Center for Research on Domestic Health Disparities to conduct and support basic and clinical research, training, and dissemination of health information, and other programs with respect to minority health.
Directs the Director of the Center to assist in the administration of certain PHSA clinical research requirements with respect to the inclusion of minority groups as clinical research subjects.
Directs the Secretary of Health and Human Services to establish an advisory council to assist the Director.
Authorizes appropriations.