Input:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Digital Trade Act of 2013''.

SEC. 2. FINDINGS; SENSE OF CONGRESS.

    (a) Findings.--Congress makes the following findings:
            (1) The Internet has become an unprecedented medium for
        competition, trade, free expression, and access to information.
            (2) The Internet is a driver of the global economy and must
        remain open, stable, and secure.
            (3) Trade in Internet-enabled services and transfers of
        data and other digital information have become increasingly
        critical drivers of the economic growth of the United States.
        The United States International Trade Commission found in a
        July 2013 report, entitled ``Digital Trade in the U.S. and
        Global Economies, Part 1'', that ``U.S. exports of digitally
        enabled services (one measure of international digital trade)
        grew from $282.1 billion in 2007 to $356.1 billion in 2011,
        with exports exceeding imports every year''.
            (4) The United States is the global leader in Internet-
        enabled platforms, networks, and services. Certain liability
        protections for those entities under the law of the United
        States, which promote innovation and creativity and allow for
        cooperative efforts to address harmful activity, have been
        critical to the growth of the Internet economy in the United
        States.
            (5) According to McKinsey & Company, more than \3/4\ of the
        value added by the Internet is in traditional industries.
            (6) Internet-enabled commerce and digital trade benefits
        small- and medium-size enterprises by providing unparalleled
        access to global markets.
            (7) Proposals have been put forward by some trading
        partners of the United States to restrict the flow of lawful
        information across borders. Those proposals would cause
        increased government control over the Internet and could create
        a fragmented Internet.
            (8) Localization barriers to trade are frequently used to
        protect, favor, or stimulate domestic industries at the expense
        of industries in other countries. Those localization
        requirements harm the competitiveness of and end-users in the
        United States.
            (9) Restrictive policies regarding the flow of information
        across borders are nontariff barriers that are harmful to
        innovation and economic advancement. Those policies impede
        trade in digital products and services and constrain the
        ability of United States companies from many sectors to
        effectively operate across borders.
            (10) Cross-border data flows are critical to manufacturers,
        institutions of higher education, hospitals, retailers,
        financial services firms, laboratories, and many other
        organizations that use the Internet to improve their
        productivity and manage global networks of customers,
        suppliers, researchers, and employees.
            (11) The free flow of information across borders provides
        choices and reduces costs to consumers worldwide.
            (12) The position of the United States Government has been
        and is to advocate for the free flow of information across
        borders.
    (b) Sense of Congress.--It is the sense of Congress that--
            (1) agencies in the executive branch, including the Office
        of the United States Trade Representative, should be staffed
        with experts and leaders to fulfill the mission of promoting an
        open, global Internet that facilitates commerce and digital
        trade; and
            (2) private sector stakeholders should have the opportunity
        to formally inform efforts of agencies in the executive branch
        related to digital trade.

SEC. 3. NEGOTIATING PRINCIPLES FOR INTERNET-ENABLED COMMERCE AND
              DIGITAL TRADE.

    It shall be a negotiating principle of the United States in
negotiations for a bilateral, plurilateral, or multilateral agreement,
and in multi-stakeholder fora, to seek the inclusion of binding and
enforceable provisions that promote and enhance Internet-enabled
commerce and digital trade, including provisions--
            (1) preventing or eliminating barriers to the movement of
        electronic information across borders, including by encouraging
        interoperability of data protection regimes and eliminating
        barriers to accessing, processing, transferring, or storing
        information;
            (2) ensuring transparency in measures affecting the free
        flow of information within and across borders;
            (3) continuing the current practice of not imposing customs
        duties on electronic transmissions;
            (4) prohibiting measures that condition market access or
        other commercial benefits on localization of data,
        infrastructure, or investment;
            (5) prohibiting any country from imposing measures that
        require an entity to use computing infrastructure or services
        in that country or otherwise require an entity to access,
        process, transfer, or store data in the territory of that
        country;
            (6) ensuring that the Internet continues to operate within
        the successful multi-stakeholder governance model;
            (7) ensuring that provisions affecting intermediary
        liability for Internet-enabled platforms, networks, and
        services are consistent with the law of the United States;
            (8) ensuring digital trade policies contemplate various
        business activities across all industrial sectors and allow for
        future technological advancement; and
            (9) otherwise eliminating discriminatory treatment of
        Internet-enabled commerce and digital trade.

Output: Digital Trade Act of 2013 - Expresses the sense of Congress that: (1) executive branch agencies, including the Office of the United States Trade Representative, should be staffed with experts and leaders to promote an open, global Internet that facilitates commerce and digital trade; and (2) private sector stakeholders should have the opportunity to inform executive agency efforts related to digital trade.  States that it shall be a U.S. negotiating principle in negotiations for a bilateral, plurilateral, or multilateral agreement, and in multi-stakeholder fora, to seek the inclusion of binding provisions that promote and enhance Internet-enabled commerce and digital trade.


Input:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Teacher Education Assistance
Creating Hope for Our Future Act of 2008'', or the ``TEACH for Our
Future Act of 2008''.

SEC. 2. FFEL PROGRAM LOAN FORGIVENESS FOR TEACHERS.

    Section 428J of the Higher Education Act of 1965 (20 U.S.C. 1078-
10) is amended--
            (1) by amending subsection (b) to read as follows:
    ``(b) Program Authorized.--
            ``(1) In general.--The Secretary shall carry out a program,
        through the holder of the loan, of assuming the obligation to
        repay a qualified loan amount for a loan made under section 428
        or 428H, in accordance with subsection (c), for any borrower--
                    ``(A) who--
                            ``(i) has been employed as a full-time
                        elementary school or secondary school teacher
                        for 5 consecutive complete school years at any
                        public school; or
                            ``(ii) is a new borrower on or after
                        October 1, 1998, and who has been employed as a
                        full-time private school teacher for 5
                        consecutive complete school years--
                                    ``(I) in a school that qualifies
                                under section 465(a)(2)(A) for loan
                                cancellation for Perkins loan
                                recipients who teach in such schools;
                                and
                                    ``(II) if employed as an elementary
                                school or secondary school teacher, is
                                highly qualified as defined in section
                                9101 of the Elementary Secondary
                                Education Act of 1965, or meets the
                                requirements of subsection (g)(3); and
                    ``(B) who is not in default on a loan for which the
                borrower seeks forgiveness.
            ``(2) Special rule.--No borrower may obtain a reduction of
        loan obligations under both this section and section 460.'';
            (2) in subsection (c)--
                    (A) by amending paragraph (1) to read as follows:
            ``(1) In general.--Of the loan obligation on a loan made
        under section 428 or 428H that is outstanding after the
        completion of the fifth complete school year of teaching
        described in subsection (b)(1)(A), the Secretary shall repay
        not more than--
                    ``(A) $25,000 in the aggregate for a borrower
                described in subsection (b)(1)(A)(i); and
                    ``(B) $5,000 in the aggregate for a borrower
                described in subsection (b)(1)(A)(ii), except as
                provided in paragraph (3) of this subsection.''; and
                    (B) in paragraph (3)--
                            (i) in the header, by inserting ``private
                        school'' before ``teachers'';
                            (ii) in subparagraph (A)(i), by striking
                        ``subsection (b)'' and inserting ``subsection
                        (b)(1)(A)(ii)'';
                            (iii) in subparagraph (B)(i), by striking
                        ``subsection (b)'' and inserting ``subsection
                        (b)(1)(A)(ii)''; and
                            (iv) in subparagraph (B)(iii), by striking
                        ``public or'' before ``non-profit''; and
            (3) in subsection (g)--
                    (A) in paragraph (1)(A), by striking ``(b)(1)(A)''
                and inserting ``(b)(1)(A)(ii)(I)''; and
                    (B) in paragraph (3), by striking ``(b)(1)(B)'' and
                inserting ``(b)(1)(A)(ii)(II)''.

SEC. 3. DIRECT LOAN PROGRAM LOAN FORGIVENESS FOR TEACHERS.

    Section 460 of the Higher Education Act of 1965 (20 U.S.C. 1087j)
is amended--
            (1) in subsection (b), by amending paragraph (1) to read as
        follows:
            ``(1) In general.--The Secretary shall carry out a program
        of canceling the obligation to repay a qualified loan amount in
        accordance with subsection (c) for Federal Direct Stafford
        Loans and Federal Direct Unsubsidized Stafford Loans made under
        this part for any borrower--
                    ``(A) who--
                            ``(i) has been employed as a full-time
                        elementary school or secondary school teacher
                        for 5 consecutive complete school years at any
                        public school; or
                            ``(ii) is a new borrower on or after
                        October 1, 1998, and who has been employed as a
                        full-time private school teacher for 5
                        consecutive complete school years--
                                    ``(I) in a school that qualifies
                                under section 465(a)(2)(A) for loan
                                cancellation for Perkins loan
                                recipients who teach in such schools;
                                and
                                    ``(II) if employed as an elementary
                                school or secondary school teacher, is
                                highly qualified as defined in section
                                9101 of the Elementary Secondary
                                Education Act of 1965, or meets the
                                requirements of subsection (g)(3); and
                    ``(B) who is not in default on a loan for which the
                borrower seeks forgiveness.'';
            (2) in subsection (c)--
                    (A) by amending paragraph (1) to read as follows:
            ``(1) In general.--Of the loan obligation on a Federal
        Direct Stafford Loan or a Federal Direct Unsubsidized Stafford
        Loan that is outstanding after the completion of the fifth
        complete school year of teaching described in subsection
        (b)(1)(A), the Secretary shall cancel not more than--
                    ``(A) $25,000 in the aggregate for a borrower
                described in subsection (b)(1)(A)(i); and
                    ``(B) $5,000 in the aggregate for a borrower
                described in subsection (b)(1)(A)(ii), except as
                provided in paragraph (3) of this subsection.''; and
                    (B) in paragraph (3)--
                            (i) in the header, by inserting ``private
                        school'' before ``teachers'';
                            (ii) in subparagraph (A)(i), by striking
                        ``subsection (b)(1)'' and inserting
                        ``subsection (b)(1)(A)(ii)'';
                            (iii) in subparagraph (B)(i), by striking
                        ``subsection (b)(1)'' and inserting
                        ``subsection (b)(1)(A)(ii)''; and
                            (iv) in subparagraph (B)(iii), by striking
                        ``public or'' before ``non-profit''; and
            (3) in subsection (g)--
                    (A) in paragraph (1)(A), by striking ``(b)(1)(A)''
                and inserting ``(b)(1)(A)(ii)(I)''; and
                    (B) in paragraph (3), by striking ``(b)(1)(A)(ii)''
                and inserting ``(b)(1)(A)(ii)(II)''.

Output:
Teacher Education Assistance Creating Hope for Our Future Act of 2008 or the TEACH for Our Future Act of 2008 - Amends the Higher Education Act of 1965 to expand the loan forgiveness available to public elementary and secondary school teachers under the Federal Family Education Loan (FFEL) and Direct Loan (DL) programs.

Makes inapplicable to public school teachers the requirements limiting loan forgiveness to: (1) new borrowers on or after October 1, 1998; and (2) highly qualified teachers in certain schools that serve a high proportion of disadvantaged students. Maintains the requirement that such teachers teach full-time for five consecutive complete school years before becoming eligible for loan forgiveness.

Raises to $25,000 the amount of the FFEL or DL outstanding that may be forgiven after a public school teacher's fifth complete school year of teaching.

Maintains current loan forgiveness eligibility requirements for private elementary and secondary school teachers.


Input:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Senator Paul Simon Water for the
Poor Enhancement Act of 2008''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) The Senator Paul Simon Water for the Poor Act of 2005
        (Public Law 109-121)--
                    (A) makes access to safe water and sanitation for
                developing countries a specific policy objective of
                United States foreign assistance programs;
                    (B) requires the Secretary of State to--
                            (i) develop a strategy to elevate the role
                        of water and sanitation policy; and
                            (ii) improve the effectiveness of United
                        States assistance programs undertaken in
                        support of that strategy;
                    (C) codifies Target 10 of the United Nations
                Millennium Development Goals; and
                    (D) seeks to reduce the proportion of people who
                are unable to reach or afford safe drinking water and
                basic sanitation by 50 percent by 2015.
            (2) On December 20, 2006, the United Nations General
        Assembly, in GA Resolution 61/192, declared 2008 as the
        International Year of Sanitation, in recognition of the impact
        of sanitation on public health, poverty reduction, economic and
        social development, and the environment.
            (3) On August 1, 2008, Congress passed H. Con. Res. 318,
        which--
                    (A) supports the goals and ideals of the
                International Year of Sanitation; and
                    (B) recognizes the importance of sanitation on
                public health, poverty reduction, economic and social
                development, and the environment.
            (4) While progress is being made on safe water and
        sanitation efforts--
                    (A) more than 884,000,000 people throughout the
                world lack access to safe drinking water; and
                    (B) 2 of every 5 people in the world do not have
                access to basic sanitation services.
            (5) The health consequences of unsafe drinking water and
        poor sanitation are staggering, accounting for--
                    (A) nearly 10 percent of the global burden of
                disease; and
                    (B) more than 2,000,000 deaths each year.
            (6) The effects of climate change are expected to produce
        severe consequences for water availability and resource
        management in the future, with 2,800,000,000 people in more
        than 48 countries expected to face severe and chronic water
        shortages by 2025.
            (7) The impact of water scarcity on conflict and
        instability is evident in many parts of the world, including
        the Darfur region of Sudan, where demand for water resources
        has contributed to armed conflict between nomadic ethnic groups
        and local farming communities.
            (8) In order to further the United States contribution to
        safe water and sanitation efforts, it is necessary to--
                    (A) expand foreign assistance capacity to address
                the challenges described in this section; and
                    (B) represent issues related to water and
                sanitation at the highest levels of United States
                foreign assistance deliberations, including
                deliberations related to issues of global health, food
                security, the environment, global warming, and maternal
                and child mortality.

SEC. 3. PURPOSE.

    The purpose of this Act is to enhance the capacity of the United
States Government to fully implement the Senator Paul Simon Water for
the Poor Act of 2005 (Public Law 109-121).

SEC. 4. DEVELOPING UNITED STATES GOVERNMENT CAPACITY.

    Section 135 of the Foreign Assistance Act of 1961 (22 U.S.C. 2151h)
is amended by adding at the end the following:
    ``(e) Office of Water.--
            ``(1) Establishment.--To carry out the purposes of
        subsection (a), the Administrator of the United States Agency
        for International Development shall establish the Office of
        Water.
            ``(2) Leadership.--The Office of Water shall be headed by
        an Assistant Administrator for Safe Water and Sanitation, who
        shall report directly to the Administrator.
            ``(3) Duties.--The Assistant Administrator shall--
                    ``(A) implement this section and the Senator Paul
                Simon Water for the Poor Act of 2005 (Public Law 109-
                121); and
                    ``(B) place primary emphasis on providing safe,
                affordable, and sustainable drinking water, sanitation,
                and hygiene.
    ``(f) Bureau of International Water.--
            ``(1) Establishment.--To increase the capacity of the
        Department of State to address international issues regarding
        safe water, sanitation, and other international water programs,
        the Secretary of State shall establish the Bureau for
        International Water within the Office of the Under Secretary
        for Democracy and Global Affairs (referred to in this
        subsection as the `Bureau').
            ``(2) Duties.--The Bureau shall--
                    ``(A) oversee and coordinate the diplomatic policy
                of the United States Government with respect to global
                freshwater issues, including--
                            ``(i) access to safe drinking water and
                        sanitation;
                            ``(ii) river basin and watershed
                        management;
                            ``(iii) transboundary conflict;
                            ``(iv) agricultural and urban productivity
                        of water resources;
                            ``(v) pollution mitigation; and
                            ``(vi) adaptation to hydrologic change due
                        to climate variability; and
                    ``(B) ensure that international freshwater issues
                are represented--
                            ``(i) within the United States Government;
                        and
                            ``(ii) in key diplomatic, development, and
                        scientific efforts with other nations and
                        multilateral organizations.''.

SEC. 5. SAFE WATER AND SANITATION STRATEGY.

    Section 6(e) of the Senator Paul Simon Water for the Poor Act of
2005 (Public Law 109-121) is amended--
            (1) in paragraph (5), by striking ``and'' at the end;
            (2) in paragraph (6), by striking the period at the end and
        inserting a semicolon; and
            (3) by adding at the end the following:
            ``(7) an assessment of the extent to which the United
        States Government's efforts are reaching the goal described in
        section 135(a)(2) of the Foreign Assistance Act of 1961 (22
        U.S.C. 2152h(a)(2)); and
            ``(8) recommendations on what the United States Government
        would need to do to help achieve the goal referred to in
        paragraph (7) if the United States Government's efforts were
        proportional to its share of the world's economy.''.

SEC. 6. DEVELOPING LOCAL CAPACITY.

    The Senator Paul Simon Water for the Poor Act of 2005 (Public Law
109-121) is amended--
            (1) by redesignating sections 9, 10, and 11 as sections 10,
        11, and 12, respectively; and
            (2) by inserting after section 8 the following:

``SEC. 9. WATER AND SANITATION MANAGERS TRAINING PROGRAM.

    ``(a) Establishment.--
            ``(1) In general.--The Secretary of State and the
        Administrator of the United States Agency for International
        Development shall establish, in every priority country, a
        program to train local, in-country water and sanitation
        managers, and other officials of countries that receive
        assistance under section 135 of the Foreign Assistance Act of
        1961 to promote the capacity of recipient governments to
        provide affordable, equitable, and sustainable access to safe
        drinking water and sanitation.
            ``(2) Coordination.--The program established under
        subsection (a) shall be coordinated by the lead country water
        manager designated in subsection (c)(2).
            ``(3) Expansion.--The Secretary and Administrator may
        establish the program described in this section in additional
        countries if the receipt of such training would be most
        beneficial, with due consideration given to good governance.
    ``(b) Designation.--The United States Chief of Mission within each
country receiving a `high priority' designation under section 6(f)
shall--
            ``(1) designate safe drinking water and sanitation as a
        strategic objective;
            ``(2) appoint an in-country water and sanitation manager
        within the Mission to coordinate the in-country implementation
        of this Act and section 135 of the Foreign Assistance Act of
        1961 with local water managers, local government officials, the
        Department of State, and the Office of Water of the United
        States Agency for International Development; and
            ``(3) coordinate with the Development Credit Authority and
        the Global Development Alliance to further the purposes of this
        Act.''.

SEC. 7. GRANTS FOR LOW COST CLEAN WATER AND SANITATION TECHNOLOGIES.

    Section 135(c) of the Foreign Assistance Act (22 U.S.C. 2152h(c))
is amended--
            (1) in paragraph (3), by striking ``and'' at the end;
            (2) in paragraph (4), by striking the period at the end;
        and
            (3) by adding at the end the following:
            ``(5) provide grants through the United States Agency for
        International Development to foster the development of low cost
        and sustainable technologies for providing clean water and
        sanitation that are suitable for use in high priority
        countries, particularly in places with limited resources and
        infrastructure.''.

SEC. 8. UPDATED REPORT REGARDING WATER FOR PEACE AND SECURITY.

    Section 11(b) of the Senator Paul Simon Water for the Poor Act of
2005, as redesignated by section 6, is amended by adding at the end the
following: ``The report submitted under this subsection shall include
an assessment of current and likely future political tensions over
water sources and an assessment of the expected impacts of global
climate change on water supplies in 10, 25, and 50 years.''.

SEC. 9. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated for fiscal year 2009 and
each subsequent fiscal year such sums as may be necessary to carry out
this Act and the amendments made by this Act.

SEC. 10. CONSTRUCTION.

    This Act shall be implemented in a manner consistent with the
Senator Paul Simon Water for the Poor Act of 2005 (Public Law 109-121).
Nothing in this Act shall be construed in such a way as to override or
take precedence over the implementation of that Act.

Output:
Senator Paul Simon Water for the Poor Enhancement Act of 2008 - Amends the Foreign Assistance Act of 1961 to direct the Administrator of the United States Agency for International Development (USAID) to establish the Office of Water which shall: (1) implement the Senator Paul Simon Water for the Poor Act of 2005; and (2) place primary emphasis on providing safe drinking water, sanitation, and hygiene.

Directs the Secretary of State to establish the Bureau for International Water within the Office of the Under Secretary for Democracy and Global Affairs which shall: (1) coordinate U.S. diplomatic policy regarding global freshwater issues; and (2) ensure that international freshwater issues are represented within the U.S. government.

Amends the Senator Paul Simon Water for the Poor Act of 2005 to: (1) direct the Secretary and the Administrator to establish in every priority country a program to train local water and sanitation managers to promote government capacity to provide access to safe drinking water and sanitation; and (2) require that the water for peace and security report includes an assessment of current and likely future political tensions over water sources and an assessment of the future impacts of global climate change on water supplies.

Amends the Foreign Assistance Act of 1961 to authorize grants through USAID to develop technologies for providing clean water and sanitation in high priority countries with limited resources and infrastructure.


Input:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Equity in Social Security Act of
2010''.

SEC. 2. TREATMENT OF PERMANENT PARTNERSHIPS UNDER TITLE II OF THE
              SOCIAL SECURITY ACT.

    (a) In General.--Section 216 of the Social Security Act (42 U.S.C.
416) is amended by adding at the end the following new subsection:

                        ``Permanent Partnership

    ``(m)(1) Notwithstanding any other provision of this title and
under regulations of the Commissioner of Social Security prescribed as
required under paragraph (3)--
            ``(A) In any case in which the Commissioner determines, in
        connection with the application by (or on behalf of) an
        individual for a benefit under this title, that a current or
        former marriage between the applicant and another individual,
        or between 2 other individuals, is a prerequisite for
        entitlement of the applicant to such benefit and the
        application designates, for treatment as such a marriage for
        purposes of such application, an arrangement between 2
        individuals of the same gender--
                    ``(i) if the Commissioner determines that such
                arrangement is (or was) a permanent partnership within
                the meaning of paragraph (2), such arrangement shall be
                treated for purposes of this title as a marriage of
                such individuals; and
                    ``(ii) each female party to such arrangement shall
                be treated as a wife with respect to such arrangement
                (referencing the other party as such individual's
                spouse in connection with such arrangement) and each
                male party to such arrangement shall be treated as a
                husband with respect to such arrangement (referencing
                the other party as such individual's spouse in
                connection with such arrangement).
            ``(B) An arrangement between individuals of the same gender
        shall be treated as a former marriage under subparagraph (A) in
        connection with an application for benefits under this title
        only if the Commissioner determines that such arrangement has
        been dissolved under the laws of the State of domicile of the
        applicant. In any case in which the Commissioner determines
        that such an arrangement has been so dissolved--
                    ``(i) the dissolution of such arrangement shall be
                treated as a divorce with respect to such arrangement;
                and
                    ``(ii) each female individual who was a party to
                such arrangement shall be treated as a divorced wife
                with respect to such arrangement (referencing the other
                party as such individual's divorced spouse in
                connection with such arrangement) and each male
                individual who was a party to such arrangement shall be
                treated as a divorced husband with respect to such
                arrangement (referencing the other party as the
                applicant's divorced spouse in connection with such
                arrangement).
            ``(C) In any case in which the Commissioner determines
        that, after an individual entitled to a monthly insurance
        benefit under section 202 became so entitled, such individual
        and another individual of the same gender have entered into an
        arrangement that constitutes a permanent partnership, such
        arrangement shall be treated as a marriage of such individuals
        for purposes of any provision of such section providing for
        termination of such entitlement upon marriage or remarriage.
            ``(D) Upon receipt by the Commissioner of an application by
        (or on behalf of) an individual for a benefit under this title
        containing certification by (or on behalf of) the applicant,
        submitted in such form and manner as shall be prescribed in
        such regulations, that the applicant is a stepchild or adopted
        child of an individual who is or was a party to an arrangement
        consisting of a permanent partnership, if such arrangement is
        treated as a marriage under subparagraph (A) and, under the
        laws of the domicile of the applicant, the applicant is, at the
        time of such application, treated as a stepchild or adopted
        child of such party to such arrangement, the applicant shall be
        treated as such a stepchild or adopted child of such party
        (referencing such party as a parent of the applicant).
            ``(E) Upon receipt by the Commissioner of an application by
        (or on behalf of) an individual for a benefit under this title
        containing certification by (or on behalf of) the applicant,
        submitted in such form and manner as shall be prescribed in
        such regulations, that the applicant is or was a party to an
        arrangement consisting of a permanent partnership and that the
        applicant is a parent of an individual who is a stepchild or
        adopted child of the applicant with respect to such
        arrangement, if such arrangement is treated as a marriage under
        subparagraph (A) and, under the laws of the domicile of the
        applicant, the applicant is, at the time of such application,
        treated as a parent of such individual with respect to such
        arrangement, the applicant shall be treated as such a parent of
        such individual (referencing such individual as a stepchild or
        adopted child of the applicant).
    ``(2) For purposes of this subsection, the term `permanent
partnership' means, in connection with any individual, a committed,
intimate arrangement which is between such individual and another
individual who have both attained 18 years of age and which has been
recognized and certified as legally valid by the State of domicile of
the applicant, in any case in which--
            ``(A) each such individual intends a lifelong commitment to
        the other;
            ``(B) such individuals are financially interdependent;
            ``(C) such individuals are unable to contract with each
        other a marriage cognizable under this title (other than as
        provided in this subsection);
            ``(D) each such individual is not a first, second, or third
        degree blood relation of the other individual, and;
            ``(E) each such individual is neither married (within the
        meaning of this title other than as provided in this
        subsection) to, nor in a relationship described in the
        preceding provisions of this paragraph with, any third
        individual.
    ``(3) The Commissioner shall prescribe such regulations as are
necessary to carry out the provisions of this subsection. In
prescribing such regulations, the Commissioner shall take into account
the laws of the State of domicile of an applicant for benefits under
this title so as to ensure that such provisions, together with the
other provisions of this title as applied in accordance with this
subsection, are appropriately coordinated with each other and with the
laws of such State.''.
    (b) Effective Date.--The amendment made by this section shall apply
with respect to monthly insurance benefits for months after November
2011 for which applications are filed after December 31, 2011, and with
respect to lump-sum death payments in connection with deaths occuring
after such date.

Output: Equity in Social Security Act of 2010 - Amends title II (Old Age, Survivors and Disability Insurance) (OASDI) of the Social Security Act to authorize the treatment of permanent partnerships between individuals of the same gender as marriage for purposes of determining entitlement to OASDI benefits.


Input:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Small Business Health Information
Technology Financing Act''.

SEC. 2. SMALL BUSINESS HEALTH INFORMATION TECHNOLOGY FINANCING PROGRAM.

    The Small Business Act (15 U.S.C. 631 et seq.) is amended by
redesignating section 44 as section 45 and by inserting the following
new section after section 43:

``SEC. 44. LOAN GUARANTEES FOR HEALTH INFORMATION TECHNOLOGY.

    ``(a) Definitions.--As used in this section:
            ``(1) The term `health information technology' means
        computer hardware, software, and related technology that
        supports the meaningful EHR use requirements set forth in
        section 1848(o)(2)(A) of the Social Security Act (42 U.S.C.
        1395w-4(o)(2)(A)) and is purchased by an eligible professional
        to aid in the provision of health care in a health care
        setting, including, but not limited to, electronic medical
        records, and that provides for--
                    ``(A) enhancement of continuity of care for
                patients through electronic storage, transmission, and
                exchange of relevant personal health data and
                information, such that this information is accessible
                at the times and places where clinical decisions will
                be or are likely to be made;
                    ``(B) enhancement of communication between patients
                and health care providers;
                    ``(C) improvement of quality measurement by
                eligible professionals enabling them to collect, store,
                measure, and report on the processes and outcomes of
                individual and population performance and quality of
                care;
                    ``(D) improvement of evidence-based decision
                support; or
                    ``(E) enhancement of consumer and patient
                empowerment.
        Such term shall not include information technology whose sole
        use is financial management, maintenance of inventory of basic
        supplies, or appointment scheduling.
            ``(2) The term `eligible professional' means any of the
        following:
                    ``(A) A physician (as defined in section 1861(r) of
                the Social Security Act (42 U.S.C. 1395x(r))).
                    ``(B) A practitioner described in section
                1842(b)(18)(C) of that Act.
                    ``(C) A physical or occupational therapist or a
                qualified speech-language pathologist.
                    ``(D) A qualified audiologist (as defined in
                section 1861(ll)(3)(B)) of that Act.
                    ``(E) A qualified medical transcriptionist who is
                either certified by or registered with the Association
                for Healthcare Documentation Integrity, or a successor
                association thereto.
                    ``(F) A State-licensed pharmacist.
                    ``(G) A State-licensed supplier of durable medical
                equipment, prosthetics, orthotics, or supplies.
                    ``(H) A State-licensed, a State-certified, or a
                nationally accredited home health care provider.
            ``(3) The term `qualified eligible professional' means an
        eligible professional whose office can be classified as a small
        business concern by the Administrator for purposes of this Act
        under size standards established under section 3 of this Act.
            ``(4) The term `qualified medical transcriptionist' means a
        specialist in medical language and the healthcare documentation
        process who interprets and transcribes dictation by physicians
        and other healthcare professionals to ensure accurate,
        complete, and consistent documentation of healthcare
        encounters.
    ``(b) Loan Guarantees for Qualified Eligible Professionals.--
            ``(1) In general.--Subject to paragraph (2), the
        Administrator may guarantee up to 90 percent of the amount of a
        loan made to a qualified eligible professional to be used for
        the acquisition of health information technology for use in
        such eligible professional's medical practice and for the costs
        associated with the installation of such technology. Except as
        otherwise provided in this section, the terms and conditions
        that apply to loans made under section 7(a) of this Act shall
        apply to loan guarantees made under this section.
            ``(2) Limitations on guarantee amounts.--The maximum amount
        of loan principal guaranteed under this subsection may not
        exceed--
                    ``(A) $350,000 with respect to any single qualified
                eligible professional; and
                    ``(B) $2,000,000 with respect to a single group of
                affiliated qualified eligible professionals.
    ``(c) Fees.--(1) The Administrator may impose a guarantee fee on
the borrower for the purpose of reducing the cost (as defined in
section 502(5) of the Federal Credit Reform Act of 1990) of the
guarantee to zero in an amount not to exceed 2 percent of the total
guaranteed portion of any loan guaranteed under this section. The
Administrator may also impose annual servicing fees on lenders not to
exceed 0.5 percent of the outstanding balance of the guarantees on
lenders' books.
    ``(2) No service fees, processing fees, origination fees,
application fees, points, brokerage fees, bonus points, or other fees
may be charged to a loan applicant or recipient by a lender in the case
of a loan guaranteed under this section.
    ``(d) Deferral Period.--Loans guaranteed under this section shall
carry a deferral period of not less than 1 year and not more than 3
years. The Administrator shall have the authority to subsidize interest
during the deferral period.
    ``(e) Effective Date.--No loan may be guaranteed under this section
until the meaningful EHR use requirements have been determined by the
Secretary of Health and Human Services.
    ``(f) Sunset.--No loan may be guaranteed under this section after
the date that is 7 years after meaningful EHR use requirements have
been determined by the Secretary of Health and Human Services.
    ``(g) Authorization of Appropriations.--There are authorized to be
appropriated such sums as are necessary for the cost (as defined in
section 502(5) of the Federal Credit Reform Act of 1990) of
guaranteeing $10,000,000,000 in loans under this section. The
Administrator shall determine such program cost separately and
distinctly from other programs operated by the Administrator.''.

SEC. 3. REGULATIONS.

    Except as otherwise provided in this Act or in amendments made by
this Act, after an opportunity for notice and comment, but not later
than 180 days after the date of the enactment of this Act, the
Administrator shall issue regulations to carry out this Act and the
amendments made by this Act.

            Passed the House of Representatives November 18, 2009.

            Attest:

                                            LORRAINE C. MILLER,

                                                                 Clerk.

Output:
Small Business Health Information Technology Financing Act - Amends the Small Business Act to authorize the Administrator of the Small Business Administration (SBA) to guarantee up to 90% of the amount of a loan, up to specified loan amounts, to a small business health professional to be used for the acquisition and installation of health information technology for the professional's medical practice. Defines the term "health information technology" to mean computer hardware, software, and related technology that supports the meaningful electronic health record use requirements of title XVIII (Medicare) of the Social Security Act and is purchased by an eligible professional to aid in the provision of health care, including electronic medical records, but excludes information technology whose sole use is financial management, maintenance of inventory of basic supplies, or appointment scheduling. Sets loan limits at $350,000 for an individual professional and $2 million for a group of affiliated professionals. Authorizes the Administrator to impose a guarantee fee on such borrowers, but prohibits any service, processing, or other fees. Allows such loans for a period of not less than one year or more than three years.

Authorizes appropriations.


Input:
SECTION 1. ELECTION TO TAKE OWNERSHIP, OR TO DECLINE OWNERSHIP, OF A
              CERTAIN ITEM OF COMPLEX DURABLE MEDICAL EQUIPMENT AFTER
              THE 13-MONTH CAPPED RENTAL PERIOD ENDS.

    (a) In General.--Section 1834(a)(7)(A) of the Social Security Act
(42 U.S.C. 1395m(a)(7)(A)) is amended--
            (1) in clause (ii)--
                    (A) by striking ``rental.--On'' and inserting
                ``rental.--
                                    ``(I) In general.--Except as
                                provided in subclause (II), on''; and
                    (B) by adding at the end the following new
                subclause:
                                    ``(II) Option to accept or reject
                                transfer of title to group 3 support
                                surface.--
                                            ``(aa) In general.--During
                                        the 10th continuous month
                                        during which payment is made
                                        for the rental of a Group 3
                                        Support Surface under clause
                                        (i), the supplier of such item
                                        shall offer the individual the
                                        option to accept or reject
                                        transfer of title to a Group 3
                                        Support Surface after the 13th
                                        continuous month during which
                                        payment is made for the rental
                                        of the Group 3 Support Surface
                                        under clause (i). Such title
                                        shall be transferred to the
                                        individual only if the
                                        individual notifies the
                                        supplier not later than 1 month
                                        after the supplier makes such
                                        offer that the individual
                                        agrees to accept transfer of
                                        the title to the Group 3
                                        Support Surface. Unless the
                                        individual accepts transfer of
                                        title to the Group 3 Support
                                        Surface in the manner set forth
                                        in this subclause, the
                                        individual shall be deemed to
                                        have rejected transfer of
                                        title. If the individual agrees
                                        to accept the transfer of the
                                        title to the Group 3 Support
                                        Surface, the supplier shall
                                        transfer such title to the
                                        individual on the first day
                                        that begins after the 13th
                                        continuous month during which
                                        payment is made for the rental
                                        of the Group 3 Support Surface
                                        under clause (i). If the
                                        supplier transfers title to the
                                        Group 3 Support Surface under
                                        this subclause, payments for
                                        maintenance and servicing after
                                        the transfer of title shall be
                                        made in accordance with clause
                                        (iv). If the individual rejects
                                        transfer of title under this
                                        subclause, payments for
                                        maintenance and servicing after
                                        the end of the period of
                                        medical need during which
                                        payment is made under clause
                                        (i) shall be made in accordance
                                        with clause (v).
                                            ``(bb) Special rule.--If,
                                        on the effective date of this
                                        subclause, an individual's
                                        rental period for a Group 3
                                        Support Surface has exceeded 10
                                        continuous months, but the
                                        first day that begins after the
                                        13th continuous month during
                                        which payment is made for the
                                        rental under clause (i) has not
                                        been reached, the supplier
                                        shall, within 1 month following
                                        such effective date, offer the
                                        individual the option to accept
                                        or reject transfer of title to
                                        a Group 3 Support Surface. Such
                                        title shall be transferred to
                                        the individual only if the
                                        individual notifies the
                                        supplier not later than 1 month
                                        after the supplier makes such
                                        offer that the individual
                                        agrees to accept transfer of
                                        title to the Group 3 Support
                                        Surface. Unless the individual
                                        accepts transfer of title to
                                        the Group 3 Support Surface in
                                        the manner set forth in this
                                        subclause, the individual shall
                                        be deemed to have rejected
                                        transfer of title. If the
                                        individual agrees to accept the
                                        transfer of the title to the
                                        Group 3 Support Surface, the
                                        supplier shall transfer such
                                        title to the individual on the
                                        first day that begins after the
                                        13th continuous month during
                                        which payment is made for the
                                        rental of the Group 3 Support
                                        Surface under clause (i) unless
                                        that day has passed, in which
                                        case the supplier shall
                                        transfer such title to the
                                        individual not later than 1
                                        month after notification that
                                        the individual accepts transfer
                                        of title. If the supplier
                                        transfers title to the Group 3
                                        Support Surface under this
                                        subclause, payments for
                                        maintenance and servicing after
                                        the transfer of title shall be
                                        made in accordance with clause
                                        (iv). If the individual rejects
                                        transfer of title under this
                                        subclause, payments for
                                        maintenance and servicing after
                                        the end of the period of
                                        medical need during which
                                        payment is made under clause
                                        (i) shall be made in accordance
                                        with clause (v).'';
            (2) in clause (iv), in the heading, by inserting ``after
        transfer of title'' after ``servicing''; and
            (3) by adding at the end the following new clause:
                            ``(v) Maintenance and servicing of group 3
                        support surface if individual rejects transfer
                        of title.--In the case of a Group 3 Support
                        Surface for which the individual has rejected
                        transfer of title under subclause (ii)(II)--
                                    ``(I) during the first 6-month
                                period of medical need that follows the
                                period of medical need during which
                                payment is made under clause (i), no
                                payment shall be made for rental or
                                maintenance and servicing of the Group
                                3 Support Surface; and
                                    ``(II) during the first month of
                                each succeeding 6-month period of
                                medical need, a maintenance and
                                servicing payment may be made (for
                                parts and labor not covered by the
                                supplier's or manufacturer's warranty,
                                as determined by the Secretary to be
                                appropriate for the Group 3 Support
                                Surface) and the amount recognized for
                                each such 6-month period is the lower
                                of--
                                            ``(aa) a reasonable and
                                        necessary maintenance and
                                        servicing fee or fees
                                        established by the Secretary;
                                        or
                                            ``(bb) 10 percent of the
                                        total of the purchase price
                                        recognized under paragraph (8)
                                        with respect to the Group 3
                                        Support Surface.''.
    (b) Effective Date.--The amendments made by this section shall take
effect on the date of enactment of this Act.

Output: Amends title XVIII (Medicare) of the Social Security Act to permit a Medicare beneficiary to elect to take, or decline to take, ownership of a Group 3 Support Surface item of complex durable medical equipment (DME) after the 13-month capped rental period ends.


Input:
SECTION 1. SAFE HARBORS TO ANTIKICKBACK CIVIL PENALTIES AND CRIMINAL
              PENALTIES FOR PROVISION OF HEALTH INFORMATION TECHNOLOGY
              AND TRAINING SERVICES.

    (a) For Civil Penalties.--Section 1128A of the Social Security Act
(42 U.S.C. 1320a-7a) is amended--
            (1) in subsection (b), by adding at the end the following
        new paragraph:
            ``(4) For purposes of this subsection, inducements to
        reduce or limit services described in paragraph (1) shall not
        include the practical or other advantages resulting from health
        information technology or related installation, maintenance,
        support, or training services.''; and
            (2) in subsection (i), by adding at the end the following
        new paragraph:
            ``(8) The term `health information technology' means
        hardware, software, license, right, intellectual property,
        equipment, or other information technology (including new
        versions, upgrades, and connectivity) designed or provided
        primarily for the electronic creation, maintenance, or exchange
        of health information to better coordinate care or improve
        health care quality, efficiency, or research.''.
    (b) For Criminal Penalties.--Section 1128B of such Act (42 U.S.C.
1320a-7b) is amended--
            (1) in subsection (b)(3)--
                    (A) in subparagraph (G), by striking ``and'' at the
                end;
                    (B) in the subparagraph (H) added by section 237(d)
                of the Medicare Prescription Drug, Improvement, and
                Modernization Act of 2003 (Public Law 108-173; 117
                Stat. 2213)--
                            (i) by moving such subparagraph 2 ems to
                        the left; and
                            (ii) by striking the period at the end and
                        inserting a semicolon;
                    (C) in the subparagraph (H) added by section 431(a)
                of such Act (117 Stat. 2287)--
                            (i) by redesignating such subparagraph as
                        subparagraph (I);
                            (ii) by moving such subparagraph 2 ems to
                        the left; and
                            (iii) by striking the period at the end and
                        inserting ``; and''; and
                    (D) by adding at the end the following new
                subparagraph:
                    ``(J) any nonmonetary remuneration (in the form of
                health information technology, as defined in section
                1128A(i)(8), or related installation, maintenance,
                support, or training services) made to a person by a
                specified entity (as defined in subsection (g)) if--
                            ``(i) the provision of such remuneration is
                        without an agreement between the parties or
                        legal condition that--
                                    ``(I) limits or restricts the use
                                of the health information technology to
                                services provided by the physician to
                                individuals receiving services at the
                                specified entity;
                                    ``(II) limits or restricts the use
                                of the health information technology in
                                conjunction with other health
                                information technology; or
                                    ``(III) conditions the provision of
                                such remuneration on the referral of
                                patients or business to the specified
                                entity;
                            ``(ii) such remuneration is arranged for in
                        a written agreement that is signed by the
                        parties involved (or their representatives) and
                        that specifies the remuneration solicited or
                        received (or offered or paid) and states that
                        the provision of such remuneration is made for
                        the primary purpose of better coordination of
                        care or improvement of health quality,
                        efficiency, or research; and
                            ``(iii) the specified entity providing the
                        remuneration (or a representative of such
                        entity) has not taken any action to disable any
                        basic feature of any hardware or software
                        component of such remuneration that would
                        permit interoperability.''; and
            (2) by adding at the end the following new subsection:
    ``(g) Specified Entity Defined.--For purposes of subsection
(b)(3)(J), the term `specified entity' means an entity that is a
hospital, group practice, prescription drug plan sponsor, a Medicare
Advantage organization, or any other such entity specified by the
Secretary, considering the goals and objectives of this section, as
well as the goals to better coordinate the delivery of health care and
to promote the adoption and use of health information technology.''.
    (c) Effective Date and Effect on State Laws.--
            (1) Effective date.--The amendments made by subsections (a)
        and (b) shall take effect on the date that is 120 days after
        the date of the enactment of this Act.
            (2) Preemption of state laws.--No State (as defined in
        section 1101(a) of the Social Security Act (42 U.S.C. 1301(a))
        for purposes of title XI of such Act) shall have in effect a
        State law that imposes a criminal or civil penalty for a
        transaction described in section 1128A(b)(4) or section
        1128B(b)(3)(J) of such Act, as added by subsections (a)(1) and
        (b), respectively, if the conditions described in the
        respective provision, with respect to such transaction, are
        met.
    (d) Study and Report To Assess Effect of Safe Harbors on Health
System.--
            (1) In general.--The Secretary of Health and Human Services
        shall conduct a study to determine the impact of each of the
        safe harbors described in paragraph (3). In particular, the
        study shall examine the following:
                    (A) The effectiveness of each safe harbor in
                increasing the adoption of health information
                technology.
                    (B) The types of health information technology
                provided under each safe harbor.
                    (C) The extent to which the financial or other
                business relationships between providers under each
                safe harbor have changed as a result of the safe harbor
                in a way that adversely affects or benefits the health
                care system or choices available to consumers.
                    (D) The impact of the adoption of health
                information technology on health care quality, cost,
                and access under each safe harbor.
            (2) Report.--Not later than three years after the effective
        date described in subsection (c)(1), the Secretary of Health
        and Human Services shall submit to Congress a report on the
        study under paragraph (1).
            (3) Safe harbors described.--For purposes of paragraphs (1)
        and (2), the safe harbors described in this paragraph are--
                    (A) the safe harbor under section 1128A(b)(4) of
                such Act (42 U.S.C. 1320a-7a(b)(4)), as added by
                subsection (a)(1); and
                    (B) the safe harbor under section 1128B(b)(3)(J) of
                such Act (42 U.S.C. 1320a-7b(b)(3)(J)), as added by
                subsection (b).

SEC. 2. EXCEPTION TO LIMITATION ON CERTAIN PHYSICIAN REFERRALS (UNDER
              STARK) FOR PROVISION OF HEALTH INFORMATION TECHNOLOGY AND
              TRAINING SERVICES TO HEALTH CARE PROFESSIONALS.

    (a) In General.--Section 1877(b) of the Social Security Act (42
U.S.C. 1395nn(b)) is amended by adding at the end the following new
paragraph:
            ``(6) Information technology and training services.--
                    ``(A) In general.--Any nonmonetary remuneration (in
                the form of health information technology or related
                installation, maintenance, support or training
                services) made by a specified entity to a physician
                if--
                            ``(i) the provision of such remuneration is
                        without an agreement between the parties or
                        legal condition that--
                                    ``(I) limits or restricts the use
                                of the health information technology to
                                services provided by the physician to
                                individuals receiving services at the
                                specified entity;
                                    ``(II) limits or restricts the use
                                of the health information technology in
                                conjunction with other health
                                information technology; or
                                    ``(III) conditions the provision of
                                such remuneration on the referral of
                                patients or business to the specified
                                entity;
                            ``(ii) such remuneration is arranged for in
                        a written agreement that is signed by the
                        parties involved (or their representatives) and
                        that specifies the remuneration made and states
                        that the provision of such remuneration is made
                        for the primary purpose of better coordination
                        of care or improvement of health quality,
                        efficiency, or research; and
                            ``(iii) the specified entity (or a
                        representative of such entity) has not taken
                        any action to disable any basic feature of any
                        hardware or software component of such
                        remuneration that would permit
                        interoperability.
                    ``(B) Health information technology defined.--For
                purposes of this paragraph, the term `health
                information technology' means hardware, software,
                license, right, intellectual property, equipment, or
                other information technology (including new versions,
                upgrades, and connectivity) designed or provided
                primarily for the electronic creation, maintenance, or
                exchange of health information to better coordinate
                care or improve health care quality, efficiency, or
                research.
                    ``(C) Specified entity defined.--For purposes of
                this paragraph, the term `specified entity' means an
                entity that is a hospital, group practice, prescription
                drug plan sponsor, a Medicare Advantage organization,
                or any other such entity specified by the Secretary,
                considering the goals and objectives of this section,
                as well as the goals to better coordinate the delivery
                of health care and to promote the adoption and use of
                health information technology.''.
    (b) Effective Date; Effect on State Laws.--
            (1) Effective date.--The amendment made by subsection (a)
        shall take effect on the date that is 120 days after the date
        of the enactment of this Act.
            (2) Preemption of state laws.--No State (as defined in
        section 1101(a) of the Social Security Act (42 U.S.C. 1301(a))
        for purposes of title XI of such Act) shall have in effect a
        State law that imposes a criminal or civil penalty for a
        transaction described in section 1877(b)(6) of such Act, as
        added by subsection (a), if the conditions described in such
        section, with respect to such transaction, are met.
    (c) Study and Report To Assess Effect of Exception on Health
System.--
            (1) In general.--The Secretary of Health and Human Services
        shall conduct a study to determine the impact of the exception
        under section 1877(b)(6) of such Act (42 U.S.C. 1395nn(b)(6)),
        as added by subsection (a). In particular, the study shall
        examine the following:
                    (A) The effectiveness of the exception in
                increasing the adoption of health information
                technology.
                    (B) The types of health information technology
                provided under the exception.
                    (C) The extent to which the financial or other
                business relationships between providers under the
                exception have changed as a result of the exception in
                a way that adversely affects or benefits the health
                care system or choices available to consumers.
                    (D) The impact of the adoption of health
                information technology on health care quality, cost,
                and access under the exception.
            (2) Report.--Not later than three years after the effective
        date described in subsection (b)(1), the Secretary of Health
        and Human Services shall submit to Congress a report on the
        study under paragraph (1).

SEC. 3. RULES OF CONSTRUCTION REGARDING USE OF CONSORTIA.

    (a) Application to Safe Harbor From Criminal Penalties.--Section
1128B(b)(3) of the Social Security Act (42 U.S.C. 1320a-7b(b)(3)) is
amended by adding after and below subparagraph (J), as added by section
1(b)(1), the following: ``For purposes of subparagraph (J), nothing in
such subparagraph shall be construed as preventing a specified entity,
consistent with the specific requirements of such subparagraph, from
forming a consortium composed of health care providers, payers,
employers, and other interested entities to collectively purchase and
donate health information technology, or from offering health care
providers a choice of health information technology products in order
to take into account the varying needs of such providers receiving such
products.''.
    (b) Application to Stark Exception.--Paragraph (6) of section
1877(b) of the Social Security Act (42 U.S.C. 1395nn(b)), as added by
section 2(a), is amended by adding at the end the following new
subparagraph:
                    ``(D) Rule of construction.--For purposes of
                subparagraph (A), nothing in such subparagraph shall be
                construed as preventing a specified entity, consistent
                with the specific requirements of such subparagraph,
                from--
                            ``(i) forming a consortium composed of
                        health care providers, payers, employers, and
                        other interested entities to collectively
                        purchase and donate health information
                        technology; or
                            ``(ii) offering health care providers a
                        choice of health information technology
                        products in order to take into account the
                        varying needs of such providers receiving such
                        products.''.

Output:
Amends title XI of the Social Security Act to exclude (provide safe harbors for) the practical or other advantages resulting from health information technology or related installation, maintenance, support, or training services from the ban on hospital payments to physicians (kickbacks) to induce reduction or limitation of services, which are subject to antikickback civil penalties. Exempts related nonmonetary remunerations meeting specified requirements from criminal penalties.

Requires the Secretary of Health and Human Services (HHS) to assess and report to Congress on the effect of these safe harbors on the health system, especially the adoption of health information technology.

Amends SSA title XVIII (Medicare) to except from the limitation on certain physician referrals the provision of health information technology and training services to health care professionals.

Requires the Secretary to assess and report to Congress similarly on the impact of this exception on the health system, especially the adoption of health information technology.


Input:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Veterans' Compensation Cost-of-
Living Adjustment Act of 2016''.

SEC. 2. INCREASE IN RATES OF DISABILITY COMPENSATION AND DEPENDENCY AND
              INDEMNITY COMPENSATION.

    (a) Rate Adjustment.--Effective on December 1, 2016, the Secretary
of Veterans Affairs shall increase, in accordance with subsection (c),
the dollar amounts in effect on November 30, 2016, for the payment of
disability compensation and dependency and indemnity compensation under
the provisions specified in subsection (b).
    (b) Amounts To Be Increased.--The dollar amounts to be increased
pursuant to subsection (a) are the following:
            (1) Wartime disability compensation.--Each of the dollar
        amounts under section 1114 of title 38, United States Code.
            (2) Additional compensation for dependents.--Each of the
        dollar amounts under section 1115(1) of such title.
            (3) Clothing allowance.--The dollar amount under section
        1162 of such title.
            (4) Dependency and indemnity compensation to surviving
        spouse.--Each of the dollar amounts under subsections (a)
        through (d) of section 1311 of such title.
            (5) Dependency and indemnity compensation to children.--
        Each of the dollar amounts under sections 1313(a) and 1314 of
        such title.
    (c) Determination of Increase.--
            (1) Percentage.--Except as provided in paragraph (2), each
        dollar amount described in subsection (b) shall be increased by
        the same percentage as the percentage by which benefit amounts
        payable under title II of the Social Security Act (42 U.S.C.
        401 et seq.) are increased effective December 1, 2016, as a
        result of a determination under section 215(i) of such Act (42
        U.S.C. 415(i)).
            (2) Rounding.--Each dollar amount increased under paragraph
        (1), if not a whole dollar amount, shall be rounded to the next
        lower whole dollar amount.
    (d) Special Rule.--The Secretary of Veterans Affairs may adjust
administratively, consistent with the increases made under subsection
(a), the rates of disability compensation payable to persons under
section 10 of Public Law 85-857 (72 Stat. 1263) who have not received
compensation under chapter 11 of title 38, United States Code.
    (e) Publication of Adjusted Rates.--The Secretary of Veterans
Affairs shall publish in the Federal Register the amounts specified in
subsection (b), as increased under this section, not later than the
date on which the matters specified in section 215(i)(2)(D) of the
Social Security Act (42 U.S.C. 415(i)(2)(D)) are required to be
published by reason of a determination made under section 215(i) of
such Act during fiscal year 2017.

SEC. 3. TRANSPORTATION OF DECEASED VETERANS TO VETERANS' CEMETERIES.

    (a) In General.--Subsection (a) of section 2308 of title 38, United
States Code, is amended to read as follows:
    ``(a) In General.--(1) The Secretary may pay, in addition to any
amount paid pursuant to section 2302 or 2307 of this title, the cost of
transportation of the deceased veteran described in paragraph (1) or
(2) of subsection (b) for burial in a national cemetery or a covered
veterans' cemetery. Such payment shall not exceed the cost of
transportation to the national cemetery nearest the veteran's last
place of residence in which burial space is available.
    ``(2) The Secretary may pay, in addition to any amount paid
pursuant to section 2302 or 2307 of this title, the cost of
transportation of the deceased veteran described in subsection (b)(3)
for burial in a national cemetery. Such payment shall not exceed the
cost of transportation to the national cemetery nearest the veteran's
last place of residence in which burial space is available.''.
    (b) Covered Veterans' Cemetery Defined.--Section 2308 of such title
is amended by adding at the end the following new subsection:
    ``(c) Covered Veterans' Cemetery Defined.--In this section, the
term `covered veterans' cemetery' means, with respect to a deceased
veteran described in subsection (b), a veterans' cemetery owned by a
State or a tribal organization (as defined in section 3765(4) of this
title) in which the deceased veteran is eligible to be buried.''.
    (c) Conforming Amendment.--Section 2308 of such title is amended in
the section heading by adding at the end the following: ``or a
veterans' cemetery''.
    (d) Clerical Amendment.--The table of sections at the beginning of
such chapter is amended by striking the item relating to section 2308
and inserting the following new item:

``2308. Transportation of deceased veterans to a national cemetery or a
                            veterans' cemetery.''.

SEC. 4. EXPANSION OF ELIGIBILITY FOR HEADSTONES, MARKERS, AND
              MEDALLIONS FOR MEDAL OF HONOR RECIPIENTS.

    Section 2306(d) of title 38, United States Code, is amended by
adding at the end the following new paragraph:
    ``(5)(A) In carrying out this subsection with respect to a deceased
individual described in subparagraph (C), the Secretary shall furnish,
upon request, a headstone or marker under paragraph (1) or a medallion
under paragraph (4) that signifies the deceased's status as a Medal of
Honor recipient.
    ``(B) If the Secretary furnished a headstone, marker, or medallion
under paragraph (1) or (4) for a deceased individual described in
subparagraph (C) that does not signify the deceased's status as a Medal
of Honor recipient, the Secretary shall, upon request, replace such
headstone, marker, or medallion with a headstone, marker, or medallion,
as the case may be, that so signifies the deceased's status as a Medal
of Honor recipient.
    ``(C) A deceased individual described in this subparagraph is a
deceased individual who--
            ``(i) served in the Armed Forces on or after April 6, 1917;
            ``(ii) is eligible for a headstone or marker furnished
        under paragraph (1) or a medallion furnished under paragraph
        (4) (or would be so eligible for such headstone, marker, or
        medallion but for the date of the death of the individual); and
            ``(iii) was awarded the Medal of Honor (including
        posthumously).''.

SEC. 5. EXPANSION OF PRESIDENTIAL MEMORIAL CERTIFICATE PROGRAM.

    (a) In General.--Section 112(a) of title 38, United States Code, is
amended by inserting after ``conditions,'' the following: ``persons
eligible for burial in a national cemetery by reason of paragraph (2),
(3), or (7) of section 2402(a) of this title,''.
    (b) Application.--The amendment made by subsection (a) shall apply
with respect to the death of a person eligible for burial in a national
cemetery by reason of paragraph (2), (3), or (7) of section 2402(a) of
title 38, United States Code, occurring before, on, or after the date
of the enactment of this Act.

SEC. 6. BURIAL PLOTS AT ARLINGTON NATIONAL CEMETERY FOR INDIVIDUALS
              AWARDED THE MEDAL OF HONOR.

    (a) Reservation.--Of the number of in-ground burial plots available
at Arlington National Cemetery as of the date of the enactment of this
Act, the Secretary of the Army shall reserve 100 such plots to inter
deceased individuals who have been awarded the Medal of Honor.
    (b) Termination.--The requirement under subsection (a) shall
terminate on the date on which the Secretary of the Army to the
Committees on Veterans' Affairs and the Committees on Armed Services of
the House of Representatives and the Senate a report on the interment
and inurnment capacity of Arlington National Cemetery that includes--
            (1) the estimated date that the Secretary determines the
        cemetery will reach maximum interment and inurnment capacity;
        and
            (2) in light of the unique and iconic meaning of the
        cemetery to the United States, recommendations for legislative
        actions and nonlegislative options that the Secretary
        determines necessary to ensure that the maximum interment and
        inurnment capacity of the cemetery is not reached until well
        into the future, including such actions and options with
        respect to--
                    (A) redefining eligibility criteria for interment
                and inurnment in the cemetery; and
                    (B) considerations for additional expansion
                opportunities beyond the current boundaries of the
                cemetery.

SEC. 7. PILOT PROGRAM ON DEPARTMENT OF VETERANS AFFAIRS VETERAN
              ENGAGEMENT TEAM EVENTS.

    (a) In General.--
            (1) Pilot program.--Beginning not later than October 1,
        2016, the Secretary of Veterans Affairs shall carry out a
        three-year pilot program under which the Secretary shall carry
        out events, to be known as ``Veteran Engagement Team events''.
        The Secretary shall ensure that such events are carried out--
                    (A) during the first year during which the
                Secretary carries out the pilot program, at least once
                a month in a location within the jurisdiction of each
                of 10 regional offices of the Department of Veterans
                Affairs, including at least two regional offices in
                each of the five districts of the Veterans Benefits
                Administration under the organization of such
                Administration in effect as of the date of the
                enactment of this Act; and
                    (B) during each of the second and third years
                during which the Secretary carries out the pilot
                program, at least once a month in a location within the
                jurisdiction of each of 15 regional offices of the
                Department, including at least three regional offices
                in each such district.
            (2) Veteran engagement team events.--During each Veteran
        Engagement Team event, the Secretary shall provide assistance
        to veterans in completing and adjudicating claims for
        disability compensation under chapter 11 of title 38, United
        States Code, and for pension under chapter 15 of such title.
        The Secretary shall ensure that--
                    (A) all Veteran Engagement Team events occur during
                the normal business hours of the sponsoring regional
                office;
                    (B) the events are carried out at different
                locations within the jurisdiction of each regional
                office and at least 50 miles from any regional office;
                    (C) a sufficient number of physicians (to be
                available for opinions only), veteran service
                representatives and rating veteran service
                representatives, and other personnel are available at
                the events to initiate, update, and finalize the
                completion and adjudication of claims;
                    (D) veterans service organizations have access to
                the events for purposes of providing assistance to
                veterans; and
                    (E) a veteran who is unable to complete and
                adjudicate a claim at an event is informed of what
                additional information or actions are needed to
                finalize the claim.
    (b) Location.--In selecting locations for Veteran Engagement Team
events under this section, the Secretary shall--
            (1) coordinate with veteran service organizations and State
        and local veterans agencies; and
            (2) seek to select locations that are community-based and
        easily accessible.
    (c) Transfer of Personnel.--
            (1) Physicians.--The Secretary may not permanently transfer
        any physician employed by the Veterans Health Administration
        for the purpose of staffing a Veteran Engagement Team event.
            (2) Payment of salaries.--Any amount payable to an employee
        of the Department for work performed at a Veteran Engagement
        Team event is payable only from amounts otherwise available for
        the payment of the salary of the employee. No additional
        amounts are authorized to be appropriated under this section
        for the payment of salaries for Department employee.
    (d) Other Authorities.--In carrying out the pilot program under
this section, the Secretary may--
            (1) coordinate with States, local governments, nonprofit
        organizations, and private sector entities to use facilities to
        host Veteran Engagement Team events for no or minimal costs;
        and
            (2) accept, on a without compensation basis, services
        provided by non-Department physicians in rendering medical
        opinions relating to claims for compensation and pension.
    (e) Customer Satisfaction Surveys.--In carrying out the pilot
program under this section, the Secretary shall collect and analyze
information about the customer satisfaction of veterans who have
received assistance at an Veteran Engagement Team event.
    (f) Reports.--Not later than April 30, 2017, and annually
thereafter beginning on October 1, 2017, for the duration of the
program, the Secretary shall submit to Congress a report on the
implementation and effectiveness of the events. Such report shall
include--
            (1) the number and types of claims completed and
        adjudicated at the events;
            (2) the number and types of claims for which assistance was
        sought at the events that were not completed or adjudicated at
        the events and the reasons such claims were not completed or
        adjudicated; and
            (3) an analysis of the customer satisfaction of veterans
        who have received assistance at an event based on the
        information collected under subsection (e).

Output: Veterans' Compensation Cost-of-Living Adjustment Act of 2016 (Sec. 2) This bill directs the Department of Veterans Affairs (VA) to increase, as of December 1, 2016, the amounts for the payment of veterans' disability compensation, additional compensation for dependents, the clothing allowance for certain disabled veterans, and dependency and indemnity compensation for surviving spouses and children. Each such increase shall be the same percentage as the increase in benefits provided under title II (Old Age, Survivors and Disability Insurance) of the Social Security Act, on the same effective date (rounded to the next lower dollar amount if the amount is not a whole dollar amount).  The VA may adjust administratively the rates of disability compensation payable to persons receiving benefits pursuant to public laws administered by the VA on December 31, 1958 (that are still in effect) who have not received service-connected disability or death compensation.   The VA shall publish such increased amounts in the Federal Register. (Sec. 3) The VA may pay the cost of transporting a deceased veteran:   who died as the result of a service-connected disability, or who died while in receipt of disability compensation, to a national cemetery or a state- or tribal-owned veterans' cemetery in which the deceased veteran is eligible to be buried, or  who has no next of kin or other person claiming the body to a national cemetery in which the deceased veteran is eligible to be buried.   Such payment shall not exceed the cost of transportation to the national cemetery nearest to the veteran's last place of residence in which burial space is available. (Sec. 4) The VA shall furnish at a private cemetery, upon request, a headstone, marker, or medallion that signifies the status of an eligible veteran who served in the Armed Forces on or after April 6, 1917, as a Medal of Honor recipient.  If the VA furnished a headstone, marker, or medallion for a deceased veteran that does not signify his or her status as a Medal of Honor recipient, the VA shall, upon request, replace that headstone, marker, or medallion with one that signifies such status.  (Sec. 5) The bill authorizes award of the Presidential Memorial Certificate to certain deceased members of the reserve components of the Armed Forces and certain deceased members of the Reserve Officers' Training Corps. (Sec. 6) The Department of the Army shall reserve 100 in-ground burial plots at Arlington National Cemetery for interment of deceased Medal of Honor recipients. Such requirement shall terminate when the Army submits a report on the cemetery's interment and inurnment capacity that includes: (1) the estimated date of achieving maximum capacity; and (2) recommendations to ensure that such capacity is not reached until well into the future, including actions to redefine interment eligibility and considerations for cemetery expansion. (Sec. 7) The VA, beginning not later than October 1, 2016, shall carry out a three-year pilot program under which the VA shall carry out Veteran Engagement Team events to assist veterans in completing VA disability and pension claims.  Such events shall be carried out:   during the first year, at least once a month within the jurisdiction of each of 10 VA regional offices, including at least 2 regional offices in each of the 5 districts of the Veterans Benefits Administration;  during each of the second and third years, at least once a month within the jurisdiction of each of 15 VA regional offices, including at least 3 regional offices in each district;  at different locations within each regional office's jurisdiction and at least 50 miles from any regional office;  during the sponsoring regional office's normal business hours; and   with a sufficient number of physicians (to be available for opinions only), veteran service and rating representatives, and other appropriate claims personnel to initiate, update, and finalize the completion and adjudication of claims.    The VA shall: (1) collect and analyze event-satisfaction information from attending veterans, and (2) report annuallys on event implementation.  The VA may not permanently transfer any Veterans Health Administration physician to staff an event.