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Introduced in House (10/25/1995)

TABLE OF CONTENTS:

Title I: Energy, Natural Resources and Environment

Subtitle A: Energy

Subtitle B: Central Utah

Subtitle C: Army Corps of Engineers

Subtitle D: Helium Reserve

Subtitle E: Territories

Title II: Agricultural Programs

Subtitle A: Extension and Modification of Various

Commodity Programs

Subtitle B: Sugar

Subtitle C: Peanuts

Subtitle D: Tobacco

Subtitle E: Planting Flexibility

Subtitle F: Miscellaneous Provisions

Title III: Commerce

Title IV: Transportation

Title V: Housing Provisions

Title VI: Indexation and Miscellaneous Entitlement-Related

Provisions

Title VII: Medicaid Reform

Subtitle A: Per Capita Spending Limit

Subtitle B: Medicaid Managed Care

Subtitle C: Additional Reforms of Medicaid Acute Care

Program

Subtitle D: National Commission on Medicaid

Restructuring

Subtitle E: Restrictions on Disproportionate Share

Payments

Subtitle F: Fraud Reduction

Title VIII: Medicare

Subtitle A: Medicare Choice Program

Subtitle B: Provisions Relating to Regulatory Relief

Subtitle C: Medicare Payments to Health Care Providers

Subtitle D: Provisions Relating to Medicare

Beneficiaries

Subtitle E: Medicare Fraud Reduction

Subtitle F: Improving Access to Health Care

Subtitle G: Other Provisions

Subtitle H: Monitoring Achievement of Medicare Reform

Goals

Subtitle I: Lock-Box Provisions for Medicare Part B

Savings from Growth Reductions

Subtitle J: Clinical Laboratories

Title IX: Welfare Reform

Subtitle A: Temporary Employment Assistance

Subtitle B: Make Work Pay

Subtitle C: Work First

Subtitle D: Family Responsibility and Improved Child

Support Enforcement

Subtitle E: Teen Pregnancy and Family Stability

Subtitle F: SSI Reform

Subtitle G: Food Assistance

Subtitle H: Treatment of Aliens

Subtitle I: Earned Income Tax Credit

Title X: Reductions in Corporate Tax Subsidies and Other

Reforms

Subtitle A: Tax Treatment of Expatriation

Subtitle B: Modification to Earned Income Credit

Subtitle C: Alternative Minimum Tax on Corporations

Importing Products into the United States at

Artificially Inflated Prices

Subtitle D: Tax Treatment of Certain Extraordinary

Dividends

Subtitle E: Foreign Trust Tax Compliance

Subtitle F: Limitation on Section 936 Credit

Title XI: Veterans' Affairs

Subtitle A: Permanent Extension of Temporary

Authorities

Subtitle B: Other Matters

Subtitle C: Health Care Eligibility Reform

Title XII: Legislative Branch

Title XIII: Miscellaneous Provisions

Title XIV: Budget Process Provisions

Subtitle B(sic): Discretionary Spending Limits

Subtitle C: Pay-As-You-Go Procedures

Subtitle D: Miscellaneous

Subtitle E: Deficit Control

Subtitle F: Line Item Veto

Subtitle G: Enforcing Points of Order

Subtitle H: Deficit Reduction Lock-box

Subtitle I: Emergency Spending; Baseline Reform;

Continuing Resolutions Reform

Subtitle J: Technical and Conforming Amendments

Subtitle K: Truth in Legislating

Common Sense Balanced Budget Act of 1995 - Title I: Energy, Natural Resources and Environment - Subtitle A: Energy - Amends the Atomic Energy Act of 1954 to exclude from the definition of "production facility" the construction and operation of a uranium enrichment facility using Atomic Vapor Laser Isotope Separation (AVLIS) technology (thus making such a facility eligible for one-step licensing).

(Sec. 1101) States that one purpose of this Act is to ensure that privatization of the U. S. Enrichment Corporation (USEC) does not result in any adverse effects on the pension benefits of employees at facilities that are operated in the performance of functions vested in USEC.

Declares that USEC shall abide by the terms of the collective bargaining agreement in effect on the privatization date at each individual facility.

Permits employees who transfer to USEC from other Federal employment to transfer their accrued retirement benefits to a USEC retirement system, or to retain their coverage under their existing Federal plan.

Terminates USEC's status as the exclusive marketing agent for the United States for entering into contracts for providing enriched uranium and uranium enrichment and related services.

Declares that the privatization of USEC shall not affect the terms, rights, or obligations of the parties to any power purchase contracts. Sets forth the effects of the transfer of uranium enrichment contracts. Declares that the United States shall remain obligated on those contracts during their term.

States that USEC shall establish prices for its products, materials, and services on a profit-making basis.

Prescribes guidelines under which the Department of Energy (DOE) shall accept responsibility for the treatment, disposal and storage of low-level radioactive waste and mixed waste.

States that, as of the privatization date, all liabilities and any judgment against the Corporation attributable to the operation of the USEC from the transition date to the privatization date shall be direct liabilities of, and judgments against, the United States.

Authorizes the Secretary of Energy to transfer raw and enriched uranium to USEC before the privatization date without charge.

Prescribes guidelines under which: (1) USEC is authorized to establish a private corporation to implement the privatization of USEC; and (2) USEC privatization may be implemented by means of a transfer of assets and liabilities to such corporation and a merger or consolidation with it. Prohibits the Secretary from allowing the privatization of USEC by means of a public offering unless the Secretary determines that the estimated gross proceeds from the USEC sale will be an adequate amount.

Limits to ten percent of the total votes of all outstanding USEC voting securities the number of securities any person may acquire or hold, directly or indirectly, during the three years following any privatization by means of a public offering.

Provides that the proceeds to the U.S. Government from privatization shall be included in the budget baseline and be counted as an offset to direct spending.

Mandates termination of any USEC license if privatization results in its being owned, controlled or dominated by a foreign entity or otherwise inimical to the security of the United States. Precludes USEC from implementing the privatization plan less than 60 days after the date that the Comptroller General presents an evaluation of the plan to the Congress.

Provides for periodic certification of USEC by the Nuclear Regulatory Commission upon privatization.

Authorizes the licensing of Corporation facilities using AVLIS technologies for uranium enrichment.

(Sec. 1102) Amends the Omnibus Budget Reconciliation Act of 1990 to repeal the termination date for Nuclear Regulatory Commission authority to assess annual charges (thus making such authority permanent).

(Sec. 1103) Amends the National Energy Conservation Policy Act to repeal the exclusion of cogeneration process from the definition of "energy savings".

(Sec. 1104) Authorizes the Director of the Federal Emergency Management Agency to assess and collect radiological emergency preparedness fees.

Subtitle B: Central Utah - Amends the Central Utah Project Completion Act to direct the Secretary of the Interior to allow for prepayment of a specified repayment contract with the Central Utah Water Conservancy District regarding municipal and industrial water delivery facilities.

Subtitle C: Army Corps of Engineers - Establishes the Army Civil Works Regulatory Program Fund as a repository for certain regulatory fees established by the Secretary of the Army.

Subtitle D: Helium Reserve - Helium Act of 1995 - Amends the Helium Act to authorize the Secretary of the Interior to: (1) enter into agreements with private parties for the recovery and disposal of helium on Federal lands; (2) grant leasehold rights to such helium; (3) store, transport, and sell crude helium; and (4) maintain and operate existing crude helium storage at the Bureau of Mines Cliffside Field.

Directs the Secretary to: (1) cease producing, refining, and marketing refined helium; and (2) dispose of all facilities, equipment, and Federal property interests relating to refined helium activities.

Requires the Secretary to impose fees for helium storage, withdrawal, or transportation services.

Prescribes guidelines for: (1) the purchase of helium by Federal agencies from certain private persons; and (2) the sale of crude helium by the Secretary. Prohibits the Secretary from making crude helium sales in amounts that will disrupt the crude helium market price. Mandates that proceeds from helium sales be paid to the Treasury.

Identifies circumstances under which the Secretary must meet a certain deadline for the elimination of helium stockpiles. Repeals the Secretary's authority to borrow under the Helium Act.

Subtitle E: Territories - Terminates annual direct financial assistance to the Government of the Northern Mariana Islands.

Title II: Agricultural Programs - Agricultural Reconciliation Act of 1995 - Subtitle A: Extension and Modification of Various Commodity Programs - Amends the Agricultural Act of 1949 (Act) to extend loan, payment, and acreage reduction programs for wheat (including the food security wheat reserve), feed grains, cotton (including cottonseed and cottonseed oil), and rice. Extends loan and payment programs for oilseeds.

(Sec. 2106) Revises specified wheat, feed grains, upland cotton, and rice deficiency payment provisions (flex acres and 50-85 and 0-85 programs).

Subtitle B: Sugar - Amends the Agricultural Act of 1949 to extend and set forth sugar price support provisions. Establishes the sugarcane target price at 18 cents per pound.

Subtitle C: Peanuts - Amends the Agricultural Act of 1949 to extend the peanut price support program.

(Sec. 2302) Amends the Agricultural Adjustment Act of 1938 to extend and revise peanut national poundage quota and acreage allotment provisions, including specified provisions regarding Texas and New Mexico.

(Sec. 2303) Revises sale, lease, or transfer of farm poundage quota provisions. Provides for: (1) quota transfers to other self-owned farms within the same State; and (2) quota sales within a State having quotas of 10,000 tons or more.

(Sec. 2304) Subjects reentered (after export) peanut products made from additional peanuts to specified marketing penalties.

(Sec. 2305) Amends the Agricultural Act of 1949 to limit price support rate increases or decreases. Establishes a special rule regarding New Mexico pools. Requires that all domestic and export peanuts comply with specified quality standards.

(Sec. 2306) Requires an annual quota peanut producer referendum regarding the poundage quota.

Subtitle D: Tobacco - Amends the Agricultural Act of 1949 to extend tobacco marketing assessment authority. States that such fees shall be used to pay for other tobacco programs not covered by user fees or other specified assessments or contributions.

(Sec. 2402) Amends the Agricultural Adjustment Act of 1938 to revise farm acreage allotment and marketing quota reduction provisions.

(Sec. 2403) Makes a specified farm reconstitution provision applicable to burley (burley) tobacco.

(Sec. 2404) Reduces a certain percentage threshold regarding disaster-transfer of flue-cured (flue-cured) tobacco quotas.

(Sec. 2405) Amends the Agricultural Act of 1949 to expand the tobacco types subject to no net cost assessment.

(Sec. 2406) Amends the Tobacco Adjustment Act of 1938 to repeal certain tobacco export reporting requirements.

(Sec. 2407) Amends the Agricultural Adjustment Act of 1938 to repeal certain flue-cured and burley marketing quota reduction provisions.

(Sec. 2408) Amends the Tobacco Inspection Act to provide for civil penalties and cease and desist orders for violations of such Act. Grants U.S. district courts jurisdiction in such matters.

(Sec. 2409) Amends the Agricultural Adjustment Act of 1938 to permit flue-cured or other tobacco quota or allotment transfers across within-State county lines if approved by producer referendum. Eliminates certain burley quota transfer provisions for Tennessee and Virginia.

(Sec. 2410) Eliminates certain tobacco exports from flue-cured and burley national marketing quota calculations.

(Sec. 2412) Revises certain burley marketing quota lease and transfer provisions.

(Sec. 2413) Increases maximum acreage transfers.

(Sec. 2414) States that performance rendered in good faith reliance upon Department of Agriculture advice or actions may be accepted as meeting appropriate marketing quota requirements.

(Sec. 2415) Harmonizes certain flue-cured and burley sales dates.

(Sec. 2416) Authorizes a recent farm purchaser to sell burley or flue-cured marketing quotas within one year of such purchase.

Subtitle E: Planting Flexibility - Amends the Agricultural Act of 1949 to state that a farm's total acreage base shall equal the sum of the farm's acreage bases for acreage reduction enrolled crops.

(Sec. 2503) Revises planting flexibility provisions.

(Sec. 2504) Bases 1996 through 2002 farm program payment yields on the 1995 crop year.

Subtitle F: Miscellaneous Provisions - Amends the Food Security Act of 1985 to reduce the maximum amount of deficiency and land diversion payments.

(Sec. 2602) Expresses the sense of the Congress that the Secretary of Agriculture and the United States Trade Representative should intensify efforts to resolve the Canadian potato trade concerns and to begin to consider dispute resolution actions under the North American Free Trade Agreement or the General Agreement on Tariffs and Trade.

Title III: Commerce - Amends the Communications Act of 1934 (the Act) to state that certain competitive bidding requirements shall not apply to licenses or construction permits issued by the Federal Communications Commission (FCC): (1) that, as the result of the FCC carrying out specified obligations, are not mutually exclusive; (2) for public safety radio services, including non-Government uses that protect the safety of life, health, and property and that are not made commercially available to the public; or (3) for initial licenses or construction permits for new terrestrial digital television (TV) services assigned by the FCC to existing terrestrial broadcast licensees to replace their current TV licenses. Extends through FY 2002 the authority of the FCC to grant such licenses or permits.

Requires the FCC to complete all actions necessary to permit the assignment, by September 30, 2002, by competitive bidding of licenses for the use of bands of frequencies that: (1) individually span not less than 25 megahertz (mhz.), unless a combination of smaller bands can reasonably be expected to produce greater receipts; (2) in the aggregate, span not less than 100 mhz.; (3) are located below three gigahertz (ghz.); and (4) as of this Act's enactment date, have not been designated by FCC regulation for assignment or identified by the Secretary of Commerce pursuant to provisions of the National Telecommunications and Information Administration Organization Act (NTIAO Act). Directs the FCC to conduct the competitive bidding for not less than one-half of such aggregate spectrum by September 30, 2001.

Requires the FCC, in making available bands of frequencies for competitive bidding, to: (1) seek to promote the most efficient use of the spectrum; (2) take into account the cost to incumbent licensees of relocating existing uses to other bands of frequencies or other means of communication and the needs of public safety radio services; and (3) comply with the requirements of international agreements concerning spectrum allocations.

Directs the FCC to notify the Secretary if the FCC: (1) is not able to provide for the effective relocation of incumbent licensees to bands of frequencies that are available to the FCC for assignment; and (2) has identified bands of frequencies that are suitable for the relocation of such licensees and that are allocated for Federal Government use but that could be reallocated pursuant to the NTIAO Act.

Amends the NTIAO Act to require the Secretary, upon receiving a notice from the FCC pursuant to this Act, to prepare and submit to the President and the Congress a report recommending for reallocation for use other than by Federal Government stations bands of frequencies that are suitable for the uses identified in the FCC's notice.

Requires the FCC to commence the Broadband Personal Communications Services C-Block auction (described in the FCC's Sixth Report and Order) not later than December 4, 1995. Ratifies and adopts the FCC's competitive bidding rules governing such auction.

Sets forth or revises provisions regarding: (1) modification of auction policy to preserve the auction value of the spectrum; (2) identification and reallocation of auctionable frequencies; and (3) allocation and assignment of frequencies identified in the second reallocation report.

(Sec. 3102) Amends the Act to direct the FCC, for FY 1996 and thereafter, to modify the application fees so that total collections for the fiscal year equal $40 million plus the amount of necessary expenses for costs related to application processing which exceeds $40 million. Directs the FCC to notify the Congress of any proposed and adopted modifications. Requires $40 million from FCC application fees to be deposited into the Treasury and used for application processing and related expenses of the FCC. Revises the schedule of application fees for personal communications services and amateur vanity call signs under the Act. Specifies that moneys received from fees established under this section shall be deposited as an offsetting collection in, and credited to, the account providing appropriations to carry out FCC functions.

Sets forth or revises provisions regarding: (1) recovery of executive and legal costs incurred by the FCC; (2) establishment and adjustment of fees; (3) regulatory fees for satellite TV operations; and (4) governmental entities use for common carrier purposes.

Directs the FCC to: (1) develop accounting systems for making adjustments authorized by the Act; and (2) annually prepare and submit to the Congress an analysis of such systems and afford interested persons the opportunity to submit comments concerning the allocation of costs, the application, and regulatory fee adjustments.

(Sec. 3103) Prohibits the FCC from: (1) renewing any analog TV license for a period that extends beyond the earlier of December 31, 2005, or one year after the date the FCC finds (based on annual surveys) that at least 95 percent of households in the United States have the capability to receive and display video signals, other than video signals transmitted pursuant to an analog TV license; or (2) issuing, after such date, any TV licenses other than advanced TV licenses.

Directs the Secretary, each calendar year from 1998 to 2005, to conduct a survey to estimate the percentage of households in the United States that have the capability to receive and display video signals other than those transmitted pursuant to an analog TV license.

Requires the FCC to: (1) ensure that, as analog TV licenses expire, the spectrum previously used for the broadcast of analog TV signals is reclaimed and reallocated so as to maximize the deployment of new services (and directs that licensees for new services be selected by competitive bidding); and (2) complete the competitive bidding procedure by May 1, 2002.

Directs the FCC to establish procedures to ensure that, within the year prior to the reversion date, the advanced TV licensees provide each requesting household with the capability to receive and display video signals for advanced TV services.

Requires: (1) each advanced TV service licensee to provide, for a minimum of five years from such date, at least one nonsubscription video service that meets or exceeds minimum technical standards established by the FCC; and (2) the FCC, to the extent technically feasible, to ensure that picture and audio quality are at least as good as that provided to recipients within the Grade B contour of an analog TV license and to revoke the license of any advanced TV licensee who fails to meet this condition of the license.

(Sec. 3104) Amends the Omnibus Budget Reconciliation Act of 1990 to extend Patent and Trademark Office user fees through 2002. Sets amounts of surcharges to be collected in FY 1999-2002.

(Sec. 3105) Repeals the authorization of transitional appropriations for the Postal Service.

Specifies that liabilities of the former Post Office Department to the Employees' Compensation Fund shall be liabilities of the Postal Service payable out of the Fund.

Title IV: Transportation - Amends Federal transportation law to make permanent the mandate for the imposition of railroad safety fees on railroad carriers.

(Sec. 4102) Amends Federal shipping law to make permanent the mandate for the imposition of tonnage duties on certain vessels.

(Sec. 4103) Directs the Administrator of General Services to sell at fair market value all rights, title, and interests of the United States in and to the land of, and improvements to, Governors Island, New York. Grants the State of New York and the city of New York the right of first refusal to purchase all or part of such Island.

(Sec. 4104) Directs the Administrator to sell at fair market the air rights adjacent to Washington Union Station, including certain air rights to be conveyed to the Administrator by the National Railroad Passenger Corporation (AMTRAK). Directs AMTRAK, as a condition of future Federal financial assistance, to convey such rights, at no charge, on or before December 31, 1995.

Title V: Housing Provisions - Amends the United States Housing Act of 1937 to make the reduction of section 8 annual rent adjustment factors for units without tenant turnover permanent.

Amends the National Housing Act to revise the maximum mortgage amount floor for single family mortgage insurance.

Revises mortgage foreclosure avoidance and borrower assistance provisions, including: (1) authorizing a partial claim payment program for up to 12 months' equivalent payments; and (2) establishment of an assignment program.

Title VI: Indexation and Miscellaneous Entitlement-Related Provisions - Amends the Internal Revenue Code to revise section one provisions so as to provide for a reduction in the annual consumer price index formula used in determining the cost-of-living adjustment of the tax tables through the calendar year 2002.

Amends title XX (Block Grants to States for Social Services) of the Social Security Act to: (1) provide for a reduction in block grants beginning with FY 1996; and (2) provide that each State shall be annually entitled to an amount equal to the lesser of 80 percent of the total it spends for services which are directed towards achieving the stated purposes of the title or the State's allotment.

Provides for the denial of unemployment compensation to: (1) individuals with income in excess of $120,000 for the most recent taxable year; and (2) individuals who voluntarily leave military service.

Title VII: Medicaid Reform - Subtitle A: Per Capita Spending Limit - Amends title XIX (Medicaid) of the Social Security Act (SSA) to specify a limit on the total amount of State expenditures for medical assistance for which Federal financial participation may be made under Medicaid in a fiscal year beginning in FY 1997, according to a prescribed formula based on certain categories of Medicaid beneficiaries. Directs the Secretary of Health and Human Services (HHS) to establish for each State a per capita medical assistance limit for each such category and for administrative expenditures for a fiscal year according to a certain formula that accounts for inflation.

Requires the Secretary to notify each State before the beginning of each fiscal year of the per capita limits established for the State for the fiscal year. Exempts certain State expenditures under Medicaid from being subject to such limits and from being taken into account in establishing them. Provides for certain adjustments to such per capita limits, and outlines enforcement provisions for assuring that payments to the States are consistent with them. Places certain restrictions on the authority of States to apply less restrictive income and resource methodologies for making certain eligibility determinations under Medicaid.

Subtitle B: Medicaid Managed Care - Repeals certain barriers to: (1) authorize States to require certain Medicaid-eligible individuals to enroll with an eligible managed care provider of their choice under contract with the State to furnish them with all medically necessary assistance as a condition of receiving Medicaid assistance; and (2) add anti-fraud and sanctions requirements applicable to eligible managed care providers.

(Sec. 7105) Provides for assuring adequacy of payments to Medicaid managed care plans and providers.

(Sec. 7107) Requires the Secretary to report to specified congressional committees on the effect of risk contracting entities and primary care case management entities on the delivery of and payment for public health services.

(Sec. 7108) Requires the Secretary and the Comptroller General to analyze and submit reports annually to specified congressional committees on rates paid for hospital services under coordinated care programs provided for under this subtitle.

Subtitle C: Additional Reforms of Medicaid Acute Care Program - Revises provisions governing the use of enrollment fees, premiums, deductions, cost-sharing, and similar charges in order to permit increased flexibility in Medicaid cost-sharing.

(Sec. 7202) Requires the Secretary to define, by regulation promulgated after consultation with States and organizations representing health care providers, those treatment services, in addition to those otherwise covered under a State Medicaid plan, that must be covered under Medicaid as measures necessary to correct or ameliorate defects and physical and mental illnesses and conditions discovered by the screening services, whether or not such services are covered under the State plan.

(Sec. 7203) Provides that no change in law which has the effect of imposing a requirement on a State under a State plan under Medicaid, and with respect to which the Secretary is required to issue regulations to carry out such requirement, shall take effect until the date the Secretary promulgates such regulation as a final regulation. Provides that any change in a regulation of the Secretary relating to the Medicaid program shall not become effective until the beginning of the fiscal year following the fiscal year in which the change was promulgated. Gives the States certain options around such requirements.

Expresses the sense of the Congress that if a State is required by future legislation to provide for additional services, eligible individuals, or otherwise incur additional costs under its Medicaid program, the Federal Government shall provide for full payment of any such additional costs for at least the first two years in which such requirement applies.

(Sec. 7204) Sets forth provisions governing the consideration of applications for Medicaid waivers (i.e. State requests for a waiver of a Medicaid provision, or of another provision of law that applies to State plans under such title), and includes certain specified waivers under SSA and later amendments.

Subtitle D: National Commission on Medicaid Restructuring - Establishes the National Commission on Medicaid Restructuring to study and make recommendations to the Congress, the President, and the Secretary regarding the need for changes in the laws and regulations regarding the Medicaid program in order to: (1) ensure adequate access to health care under such program for low-income individuals; (2) promote quality health care; (3) deter Medicaid fraud and abuse; (4) provide States with additional flexibility in implementing their Medicaid plans; and (5) contain Federal and State Medicaid costs. Authorize appropriations.

Subtitle E: Restrictions on Disproportionate Share Payments - Revises provisions governing Medicaid payment adjustments for inpatient hospital services furnished by disproportionate share hospitals (DSH), among other changes, establishing a new national DSH payment limit and modifying provisions for determination of State DSH allotments.

Subtitle F: Fraud Reduction - Directs the Administrator of the Health Care Financing Administration (HCFA) to develop mechanisms to better monitor and prevent inappropriate payments under Medicaid in the case of individuals who are dually eligible for benefits under such program and the Medicare program under SSA title XVIII. Requires the Administrator to develop improved mechanisms, such as picture identification documents and smart documents, to provide methods of improved identification and tracking of beneficiaries and providers that perpetrate fraud against Medicaid.

Title VIII: Medicare - Medicare Preservation Act of 1995 - Amends SSA titles XI and XVIII and the Internal Revenue Code, restructuring the current Medicare program, and creating a new Medicare Choice program within it, while also providing for corresponding tax incentives for Medicare Choice medical savings accounts (MSAs) and other Medicare Choice-related matters.

Subtitle A: Medicare Choice Program - Gives individuals entitled to benefits under Medicare part A (Hospital Insurance) and enrolled under Medicare part B (Supplementary Medical Insurance) the opportunity to elect Medicare coverage during annual, coordinated election periods under either the new Medicare Choice benefit package or through the existing fee-for-service system under such parts. Includes in the Medicare Choice benefit package a high ($10,000) deductible-Medisave product under a specified demonstration plus contributions to Medicare Choice MSAs, as well as separate fee-for-service products and products offered under certain provider- and union-sponsored plans by qualified Medicare Choice organizations.

Directs the Secretary to provide for a nationally coordinated educational and publicity campaign to inform individuals who are eligible to elect Medicare Choice products about them and the election processes provided under this subtitle.

Directs the Secretary to conduct demonstration projects to test alternative approaches to coordinated open enrollments in different markets, including different annual enrollment periods and models of rolling open enrollment periods.

(Sec. 8002) Requires qualified Medicare Choice organizations (except those with union sponsors, Taft-Hartley sponsors, or, for a limited time, provider sponsors) to be licensed under State law in each State in which they offer a Medicare Choice product.

Requires such organizations to assume full financial risk on a prospective basis for the provision of health care services (other than hospice care). Allows an organization to obtain insurance in specified circumstances.

Sets forth requirements relating to benefits, provision of services (including limited physician incentive plans), enrollment, and premiums.

Specifies patient protection standards, including those for information disclosure, access to services, out-of-network services, mandatory quality assurance programs, coverage determinations, grievances, appeals, and fair marketing procedures.

Directs the Secretary to provide for demonstration projects to determine the effectiveness, cost, and impact of alternative methods of providing comparative information about the performance of Medicare Choice organizations and products and the performance of Medicare supplemental policies in relation to such products.

Prescribes policy for payments to Medicare Choice organizations, including monthly adjusted capitation rates.

Requires the Secretary to issue interim regulations regarding standards for Medicare Choice organizations and products within 180 days after the date of enactment of this subtitle, with such regulations to be effective through the end of 1999. Directs the Secretary to develop permanent standards under this subtitle, consulting with the National Association of Insurance Commissioners in doing so, with such standards to be effective for periods beginning on or after January 1, 2000.

Directs the Secretary to establish a process for the certification of Medicare Choice organizations and products. Involves the Secretary of Labor in such process with respect to union sponsors and Taft-Hartley sponsors. Outlines the certification process, including the use of private accreditation processes.

Requires Medicare Choice organizations to contract with the Secretary, subject to specified requirements.

Permits certain demonstration projects for high deductible-Medisave products, and lists special rules relating to enrollment and benefits with regard to such products, requiring, among other things, payments to the Medicare Choice MSAs of individuals electing high deductible-Medisave products under such projects.

(Sec. 8003) Directs the Secretary to report to the Congress on alternative provider payment approaches under Medicare along with recommendations for implementing and testing such approaches and any legislation that may be required for such purpose. Directs the Secretary to work with employers and health benefit plans to develop standards and payment methodologies to allow retired workers to continue to participate in employer health plans instead of participating in the Medicare program. Provides for a similar congressional report with regard to such matter.

(Sec. 8004) Sets forth transition rules for current Medicare health maintenance organization (HMO) programs.

(Sec. 8011) Amends the Internal Revenue Code to exclude from an individual's gross income any Federal payment to his or her Medicare Choice MSA, but include any MSA distribution not used to pay the account holder's qualified medical expenses. Excludes the value of such an MSA from the account holder's gross estate. Exempts an account holder from the excise tax on prohibited transactions even if an MSA ceases to be a Medicare Choice MSA because a distribution was not used to pay qualified medical expenses. Excludes further from gross income any Medicare part B premium discount rebate.

(Sec. 8021) Declares that, in any Federal or State antitrust action, the conduct of a provider service network (and any member of such network) in negotiating, making, or performing a contract, to the extent such contract is for providing services under a Medicare Choice provider-sponsored organization (PSO) contract, shall not be illegal per se. Subjects such conduct to the antitrust rule of reason standard.

(Sec. 8031) Amends SSA title XVIII to establish the Medicare Payment Review Commission (replacing the Prospective Payment Assessment Commission (ProPAC) and the Physician Payment Review Commission (PPRC), hereby abolished) which shall, among other things, review program payment policies (including those under the new Medicare Choice program) for appropriate recommendations to the Congress concerning such policies. Authorizes appropriations.

(Sec. 8032) Creates the Commission on the Effect of the Baby Boom Generation on the Medicare Program to: (1) examine the financial impact on the Medicare program of the significant increase in the number of Medicare-eligible individuals which will occur beginning approximately 2010 and last for approximately 25 years; and (2) make specific recommendations to the Congress about a comprehensive approach to preserve Medicare for the period during which such individuals are Medicare-eligible. Authorizes appropriations.

(Sec. 8041) Preempts State law restrictions on managed care arrangements and utilization review programs.

Subtitle B: Provisions Relating to Regulatory Relief - Amends SSA titles XI and XVIII, as well as the Omnibus Budget Reconciliation Act of 1993, to outline various specified revisions to Medicare physician referral prohibitions and anti-kickback and other penalties for the purpose of achieving Medicare regulatory relief.

(Sec. 8101) Includes among such revisions: (1) removal of compensation arrangements from the proscribed financial arrangements between a physician and any entity to which he or she may refer a Medicare beneficiary (thus limiting proscribed financial arrangements to an ownership or investment interest in the entity); (2) limitation of the designated health services subject to such prohibition to items and services furnished by a community pharmacy, magnetic resonance imaging and computerized tomography services, and outpatient physical therapy services; (3) repeal of the mandate for the Medicare and Medicaid Coverage Data Bank; and (4) the issuance of advisory opinions under SSA title XI.

(Sec. 8104) Revises exceptions to the prohibition against physician referrals to an entity in which the referring physician has an ownership or investment relationship to: (1) repeal the site-of-service requirement for excepted in-office ancillary services; (2) revise the exceptions for services furnished in a rural area and for pre-paid plans; and (3) add new exceptions for shared facility services and services furnished in communities with no alternative providers, in ambulatory surgical centers, in renal dialysis facilities, in a hospice, or in a comprehensive outpatient rehabilitation facility.

(Sec. 8111) Directs the Attorney General to provide for the development and publication of explicit guidelines on the application of antitrust laws to the activities of health plans, and establish a review process under which a plan administrator or sponsor may submit a request to obtain a prompt opinion from the Department of Justice (DOJ) on the plan's conformity with the Federal antitrust laws.

(Sec. 8112) Outlines requirements for issuance (or denial) by the Attorney General of health care certificates of public advantage to requesting eligible health care collaborative activities if the benefits likely to result from such an activity outweigh any reduction in competition likely also to result and if such reduction is necessary to obtain benefits. Provides for judicial review with regard to such matter.

(Sec. 8113) Requires the Attorney General, to report annually to the Congress, as part of the annual budget oversight proceedings, on DOJ's Antitrust Division in order for the Congress to determine how enforcement of antitrust laws is affecting the formation of joint ventures, and if such certificates have resulted in undesirable reduction in competition in the health care marketplace.

(Sec. 8114) Exempts specified antitrust laws, under certain conditions, from applying with respect to: (1) the merger of, or the attempt to merge, two or more hospitals; (2) a contract entered into solely by two or more hospitals to allocate hospital services; or (3) the attempt by only two or more hospitals to enter into a contract to allocate hospital services.

(Sec. 8121) Outlines various specified measures with respect to health care liability designed to provide for malpractice reform that, among other things, include: (1) a statute of limitations for medical malpractice claims, with exceptions for minors; (2) a limitation on noneconomic damages; and (3) standards for using alternative dispute resolution (ADR) in such matters as an initial attempt to resolve them before they may be brought in State or Federal court. Includes special provisions for certain obstetric services. Requires certain reports on the implementation and effectiveness of ADR systems for the Congress.

(Sec. 8151) Modifies under Medicare the payment areas used to determine Medicare payments for physicians' services under such program while ensuring budget-neutrality.

Subtitle C: Medicare Payments to Health Care Providers - Provides for a one-year general freeze in payments to Medicare providers during FY 1996, with similar freezes for skilled nursing facilities and home health agencies under the Omnibus Budget Reconciliation Act of 1993.

(Sec. 8211) Revises Medicare provisions for payments for physicians' services, replacing the volume performance standard with sustainable growth rate and establishing a single conversion factor for 1996, among other changes.

(Sec. 8221) Provides for a reduction in update for inpatient hospital services for FY 1997 through 2002.

(Sec. 8222) Eliminates formula-driven overpayments for ambulatory surgical center procedures and radiology services and diagnostic procedures.

(Sec. 8223) Requires the Secretary to establish a prospective payment system (PPS) for hospital outpatient services.

(Sec. 8224) Reduces Medicare payments to hospitals for inpatient capital-related costs.

(Sec. 8225) Places a moratorium on PPS exemption for long term care hospitals.

Directs the Secretary to submit to the Congress recommendations for modifications to the standards used to determine whether a hospital is classified as a long-term care hospital for purposes of determining the amount of payment to the hospital under Medicare part A for the operating costs of inpatient hospital services.

(Sec. 8231) Sets forth provisions affecting home health and other specified providers, including providers of durable medical equipment and nursing homes, with similar payment changes and reductions and certain coverage limitations and incentives for cost-efficient management. Requires the Secretary to expand PPS research for home health agencies.

(Sec. 8235) Freezes payments for clinical diagnostic laboratory tests.

(Sec. 8241) Adds a new SSA title XXI (Teaching Hospitals and Graduate Medical Education Trust Fund) establishing in the Treasury the Teaching Hospital and Graduate Medical Education Trust Fund for payments to teaching hospitals out of specified transfers from the Medicare trust funds and other amounts. Provides within HHS for a temporary advisory counsel (the National Advisory Council on Postgraduate Medical Education) to advise the Secretary on postgraduate medical education financing for assuring an adequate supply of trained specialists consistent with our country's health care needs.

(Sec. 8242) Modifies payment policies under Medicare regarding indirect costs of graduate medical education, reducing payment adjustments for indirect medical education.

Subtitle D: Provisions Relating to Medicare Beneficiaries - Makes specified changes with regard to the Medicare part B premium, including freezing it for 1996.

(Sec. 8302) Amends the Internal Revenue Code to make the full cost of Medicare part B coverage payable by high-income individuals.

(Sec. 8303) Provides annual screening mammography for women over age 49, plus expanded coverage of other preventive benefits under Medicare such as colorectal screening, prostate cancer screening tests and diabetes outpatient self-management training services.

Subtitle E: Medicare Fraud Reduction - Outlines various specified measures designed for preventing fraud and abuse under the Medicare program or a State health care program, including among them in addition to the special fraud alerts initially set out: (1) special outreach and other efforts by the Secretary which include establishing a beneficiary incentive program for collecting information on fraud and abuse under Medicare; (2) establishment of the Medicare Integrity Program and associated Anti-Fraud and Abuse Trust Fund for contracting out to eligible private entities specified anti-fraud and abuse activities; (3) establishment by the Secretary of certain fraud reduction demonstration projects; and (3) provide direct spending for Medicare-related anti-fraud activities of the HHS Inspector General. Provides appropriations from the Anti-Fraud and Abuse Trust Fund to carry out the Medicare Integrity Program.

(Sec. 8407) Requires the Secretary to recommend to the Congress legislative changes to the Medicare program to enable the prices paid for items and services under it to be established on a more competitive basis.

Subtitle F: Improving Access to Health Care - Outlines various specified changes with regard to rural hospitals for the purpose of improving access to health care in rural areas, among other changes, by establishing a rural emergency access care hospital program and a system of additional payments under Medicare for physicians' services furnished in shortage areas. Reduces updates for sole community hospitals. Requires the Medicare Payment Review Commission to study and report to the Congress on the impact of the designation of hospitals as sole community hospitals under the Medicare program on the delivery of health care services to individuals in rural areas. Prohibits denial of request for reclassification of rural referral centers on basis of comparability of wages. Provides for State and consortium demonstration projects for increasing the number of medical students entering primary case practice relative to those entering nonprimary care practice. Requires the Secretary to develop and publish a model law that may be adopted by States to increase the access of individuals residing in underserved rural areas to health care services by expanding the services which non-physician health care professionals may provide in such areas.

(Sec. 8512) Amends the Internal Revenue Code to exclude national health service corps loan repayments from gross income.

(Sec. 8513) Directs the Secretary to establish a methodology for making payments under Medicare part B for telemedicine services furnished on an emergency basis to individuals residing in an area designated as a health professional shortage area.

(Sec. 8514) Provides for an HHS demonstration project to assess the advantages and disadvantages of requiring Medicare Choice organizations to market their products in certain underserved areas which are near the standard service area for such products.

(Sec. 8521) Provides for Medicare program payments for health care services provided in the military health services system.

Subtitle G: Other Provisions - Provides, with regard to Medicare as secondary payer, for: (1) extension and expansion of existing requirements; (2) recovery against third party administrators of primary plans; and (3) prohibition of retroactive application (before April 24, 1995) of a certain policy directive regarding end stage renal disease beneficiaries enrolled in primary plans.

(Sec. 8602) Repeals the Medicare and Medicaid Coverage Databank under SSA title XI.

(Sec. 8603) Provides that nothing in SSA title XVIII may be construed to prohibit coverage under Medicare part A or B of items and services associated with the use of a medical device in the furnishing of inpatient hospital services solely on the grounds that the device is not an approved device, if it is an investigational device and is used instead of an approved device.

States that the amount of Medicare payment for any item or service associated with the use of an investigational device in the furnishing of such services may not exceed the amount of the payment which would have been made for the item or service if it were associated with the use of an approved device.

(Sec. 8604) Excludes from Medicare coverage items or services used for euthanasia.

(Sec. 8605) Extends Medicare coverage of, and application of the hospital insurance tax to, all State and local government employees. Authorizes appropriations.

Subtitle H: Monitoring Achievement of Medicare Reform Goals - Directs the Secretary to establish budgetary and program goals for the Medicare program that are consistent with: (1) specified restrictions on total Medicare outlays for FY 1996 through FY 2002; and (2) an equitable distribution of funds between per beneficiary spending on payments to Medicare Choice organizations and spending on fee-for-service payments to Medicare providers. Requires such goals also to be consistent with the establishment of payments to such organizations in a manner that: (1) promotes the availability of Medicare Choice products in all regions of the country; and (2) permits such organizations to offer adequate coverage.

(Sec. 8702) Establishes the Medicare Reform Commission to examine how Medicare has met such goals, with recommendations concerning any problems found to exist submitted to the President for transmittal with corrections to the Congress for action. Authorizes appropriations.

Subtitle I: Lock-Box Provisions for Medicare Part B Savings from Growth Reductions - Establishes under Medicare part B in the Treasury the Federal Medicare Growth Reduction Trust Fund for the savings under such part that are attributable to this Act.

Subtitle J: Clinical Laboratories - Amends the Public Health Service Act to exempt from certification requirements under such Act clinical laboratories in physician offices (except when pap smear analysis is performed).

Title IX: Welfare Reform - Subtitle A: Temporary Employment Assistance - Replaces the current Aid to Families with Dependent Children (AFDC) Program under SSA title IV part A with a Temporary Employment Assistance (TEA) program for the purpose of providing assistance to families with needy children and assisting parents of such children to obtain and retain private sector work to the extent possible, and public sector or volunteer work if necessary, through the Work First Employment Block Grant program. Authorizes appropriations.

(Sec. 9101) Sets forth State TEA plan elements necessary for plan approval by the Secretary of Health and Human Services (HHS). Includes among them, in addition to certain administrative requirements for ensuring that families on TEA assistance become self-sufficient, the following key elements: (1) limited time for cash assistance, with specified exceptions for teen parents, hardship situations, and individuals exempt from certain work requirements under this title because of illness or other specified reasons; (2) assessment, before such individuals may receive TEA assistance, of the skills, prior work experience, and employability of each applicant for, and recipient of, TEA assistance who has attained age 18 or has not obtained a high school education, and is not attending secondary school; (3) development of an individual responsibility plan on the basis of such assessment, setting forth certain job search, work-, and education-related obligations (including, at State option, appropriate substance abuse treatment) of such individuals in order for them to receive the full amount of TEA assistance (denying it for plan noncompliance after the third offense); (4) State operation a Work First Program (replacing the current Job Opportunities and Basic Skills Training (JOBS) program) and a workfare or job placement voucher program for individuals prohibited from participation in the Work First program; (5) assurance that all such applicants and recipients will cooperate in paternity establishment and enforcement of child support obligations, and that the State agency will report known or suspected instances of child abuse to the appropriate authorities; (6) State efforts to promote family preservation and stability; and (7) denial of TEA assistance for fraudulent statements made with regard to residence in order to obtain multiple assistance payments and for probation and parole violators.

Outlines State payment and miscellaneous State plan quality assurance and data collection, compilation, and reporting requirements, as well as certain research, demonstration, and evaluation requirements (including requirements for the Secretary to establish certain regional information centers for disseminating information concerning welfare reform) with regard to the different State approaches to operating welfare programs under this subtitle.

Provides that, upon receiving notice from a State agency administering an approved plan that a named individual has been overpaid under it, the Secretary of the Treasury shall: (1) determine whether any tax refunds are payable to such individual, regardless of whether he or she filed a return as a married or unmarried individual; and (2) withhold from any such refunds an amount equal to the overpayment sought to be collected, and pay it to the State agency. Requires the Secretary to issue regulations allowing a State to submit requests for collection of overpayments only with respect to individuals no longer receiving TEA assistance against whom the State has already taken appropriate action, including notice of its intent to request such withholding of income tax refunds.

Specifies rules for the collection of overpayments under SSA title IV part A.

Subtitle B: Make Work Pay - Amends SSA title XIX (Medicaid) to give States the option of providing for an extension of Medicaid enrollment for former AFDC recipients for one additional year.

(Sec. 9202) Requires State TEA, food stamp, and Medicaid plans to provide their respective applicants and former recipients with written notice of the existence and availability of the earned income tax credit, with changes under the Omnibus Budget Reconciliation Act of 1990 providing for such notice of availability to be included on employee W-4 forms.

(Sec. 9204) Amends the Internal Revenue Code (IRC) to provide for State demonstrations for advance payment of earned income tax credit. Authorizes appropriations.

(Sec. 9205) Repeals the Child Care and Development Block Grant Act of 1990 and provides for funding of child care services through the program under SSA title XX (Block Grants to States for Social Services), with limited funding for child care grants under such program to supplement State and local funds as well as Federal funds provided under other Acts for child care activities. Requires the appropriate State agencies under such program to guarantee child care for participants involved in the education, training, community service, and employment initiatives above connected with State TEA programs.

(Sec. 9206) Amends IRC to: (1) include TEA, food stamp, and supplemental security income (SSI) assistance in gross income and exclude such benefits from being taken into account for purposes of the earned income tax credit; and (2) make the dependent care credit refundable and exclude certain high-income taxpayers from being eligible for such credit.

Subtitle C: Work First - Replaces the JOBS program under SSA title IV part F with the Work First program under which States have the option of offering a wide variety of job-related activities (including use of job placement companies) to TEA program participants in order to provide them in a cost-effective fashion with the support and skills necessary to obtain and keep full-time unsubsidized employment, preferably in the private sector.

(Sec. 9301) Outlines various specified: (1) program components, including microenterprise initiatives, workfare or community service programs, work supplementation programs for jobs with the State or jobs subsidized by the State in the private sector, job placement voucher programs for States not operating a workfare or community service program, and mandatory job search requirements; and (2) associated rules, cost limits, participation and funding requirements, and performance standards for measuring the effectiveness of such programs.

Expresses the intent of the Congress that State job-related activities emphasize the use of funds that would otherwise be used to provide individuals with TEA and food stamps to subsidize the wages of such individuals in temporary jobs.

Expresses the sense of the Congress that States should target individuals below age 25 for participation in the Work First program in order to break the cycle of welfare dependency.

Subtitle D: Family Responsibility and Improved Child Support Enforcement - Chapter 1: Eligibility and Other Matters Concerning Title IV-D Program Clients - Amends part D (Child Support and Establishment of Paternity) of title IV of the Social Security Act (SSA) to require States to have statutorily prescribed procedures to: (1) record child support orders in a central case registry; and (2) collect child support payments through a centralized collections unit. Permits parties to a child support order to opt for an alternative payment procedure.

(Sec. 9401) Revises the guidelines for: (1) State plans for child and spousal support; and (2) payments distribution.

(Sec. 9403) Requires State plans to establish procedural guidelines for: (1) notification of all proceedings and orders affecting child support obligations; and (2) privacy safeguards regarding paternity and child support actions.

Chapter 2: Program Administration and Funding - Revises the formula for: (1) Federal matching payments to the States; and (2) incentive adjustments to the Federal matching rate.

(Sec. 9413) Requires a State plan for child and spousal support to include prescribed procedures for State reviews and audits. Revises the guidelines for Federal evaluation and audit of State programs governing paternity, child and spousal support, and parent location.

(Sec. 9415) Revises the automated data processing requirements for State plans to mandate a single statewide automated data processing and information retrieval system which can perform specified tasks.

(Sec. 9416) Directs the Secretary of Health and Human Services to conduct staffing studies of each State child support enforcement program and to report the results to the Congress.

(Sec. 9417) Makes funds available to the Secretary for: (1) training of Federal and State staff, research and demonstration programs, and special projects of regional and national significance; and (2) operation of the Federal Parent Locator Service.

Chapter 3: Locate and Case Tracking - Mandates that the single statewide automated data system function as a single central case registry of State-provided services and support orders. Delineates contents of case records and data matching activities, including data exchange with sister States.

(Sec. 9422) Requires State plans to include a centralized, automated unit for the collection and disbursement of support payments.

(Sec. 9423) Requires the States to have statutorily prescribed procedures: (1) for mandatory income withholding for support payments subject to enforcement; and (2) under which child support orders issued before October 1, 1996, shall become subject to withholding from wages if arrearages occur, without the need for a judicial or administrative hearing. Revises the procedural guidelines for income withholding for child support enforcement.

(Sec. 9425) Revises the Federal Parent Locator Service to add kinds of information which may be transmitted to locate individuals and assets for purposes of establishing parentage and executing child support obligations. Requires the Secretary to establish in the Service a Data Bank of Child Support Orders and an automated directory of New Hires.

(Sec. 9426) Requires State plans to include procedures for recording social security numbers on certain family legal documents and records.

Chapter 4: Streamlining and Uniformity of Procedures - Requires each State to have the Uniform Interstate Family Support Act in effect as of January 1, 1997.

(Sec. 9432) Amends the Federal judicial code to revise the procedures for a court to apply when determining which State order to recognize for purposes of continuing, exclusive jurisdiction and enforcement for child support orders.

(Sec. 9433) Amends SSA title IV part D to revise State plan guidelines for mandatory expedited administrative and judicial procedures to include: (1) authorized genetic testing to establish paternity; and (2) the securing of assets and increasing of monthly payments to satisfy a support arrearage.

Chapter 5: Paternity Establishment - Expresses the sense of the Congress that social services should be provided in hospitals to women who have become pregnant as a result of rape or incest.

(Sec. 9442) Requires State laws to prescribe procedures for parenting counseling for new fathers that stresses the importance of paying child support.

(Sec. 9443) Requires State plans to prescribe specified administrative procedures governing agency determination as to whether an individual is cooperating with efforts to establish paternity and secure support, or has good cause not to cooperate with such efforts.

(Sec. 9444) Increases the base matching rate for Federal payments to the States for grants for dependent children.

(Sec. 9445) Revises the guidelines for statutorily prescribed procedures governing genetic testing and outreach for voluntary paternity acknowledgment.

Chapter 6: Establishment and Modification of Support Orders - Establishes the National Child Support Guidelines Commission to develop a national child support guideline for consideration by the Congress that is based on a study of various guideline models, the benefits and deficiencies of such models, and any needed improvement.

(Sec. 9452) Revises the requirements for State plan procedures for the review and adjustment of support orders.

Chapter 7: Enforcement of Support Orders - Amends the Internal Revenue Code to revise the order of refund distribution with respect to past-due support owed to individuals.

(Sec. 9463) Amends SSA title IV part D to revise procedural guidelines for: (1) consent by the United States to income withholding, garnishment, and similar proceedings for enforcement of child support and alimony obligations of current and retired Federal employees; and (2) enforcement of child support obligations of current and retired members of the armed forces.

(Sec. 9465) Requires States to have statutorily prescribed procedures for: (1) placing liens for child support arrearages on motor vehicle titles of the debtor; (2) voiding fraudulent transfers by a child support debtor; (3) suspending any driver's, business, or occupational license issued to any person who owes past-due child support; (4) reporting to credit bureaus the name of the parent in arrears for child support; (5) extending the statute of limitations for collection of child support arrearages; and (6) calculating interest or penalties on such arrearages.

(Sec. 9471) Prescribes procedural guidelines for passport denial (including revocation) upon certification of nonpayment of child support.

(Sec. 9472) Expresses the sense of the Congress that the United States should ratify the United Nations Convention of 1956. Requires State plans to provide that the State must treat international child support cases as interstate cases.

(Sec. 9473) Requires States to have statutorily prescribed procedures under which failure to pay child support arrearages results in seizure by a State agency of: (1) insurance settlements or payouts; (2) judicial awards; (3) sale of forfeited property; and (4) bequests.

(Sec. 9474) Requires State plans to include procedures under which grandparents are liable for the financial support of the children of their minor children.

(Sec. 9475) Expresses the sense of the Congress that the States should develop programs specifically designed to work with noncustodial parents who are unable to meet their child support obligations.

Chapter 8: Medical Support - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to include within the definition of medical child support order an order issued through a State administrative process.

Chapter 9: Food Stamp Program Requirements - Amends the Food Stamp Act of 1977 to set forth as a prerequisite to eligibility for the Food Stamp Program cooperation by the custodial parent with child support agencies regarding paternity and child support.

(Sec. 9492) Denies eligibility to participate in the Food Stamp Program to any individual that is delinquent in any court-ordered payment for child support.

Chapter 10: Effect of Enactment - Sets forth effective dates for portions of this title.

Subtitle E: Teen Pregnancy and Family Stability - Amends Title IV part A (AFDC) to prescribe guidelines under which State plans may deny temporary employment assistance to recipient families having additional children while receiving such assistance.

(Sec. 9502) Requires State plans to set as a prerequisite for temporary employment assistance to pregnant unwed minors (or minors with needy children in their care), that such individuals reside in certain supervised living arrangements with an adult relative or legal guardian.

(Sec. 9503) Amends title XX (Block Grants to States for Social Services) to establish a National Clearinghouse on Adolescent Pregnancy Prevention Programs. Enumerates maximum grant amounts for such Clearinghouse.

(Sec. 9504) Amends Title IV part A (AFDC) to require that State plans mandate completion of high school or other training for custodial teenage parents who are required to participate in the Work First program. Authorizes States to provide additional incentives and penalties to encourage teen parents to complete high school and participate in parenting activities.

(Sec. 9505) Denies Federal housing benefits to minors who bear children out-of-wedlock, with specified exceptions.

(Sec. 9506) Amends Title IV part A (AFDC) to prescribe guidelines under which State plans are granted the option of denying temporary employment assistance to minor parents.

Subtitle F: SSI Reform - Amends SSA title XVI (Supplemental Security Income) (SSI) to revise the rules with respect to childhood eligibility, with corresponding changes to childhood SSI regulations modifying the medical criteria for evaluation of mental and emotional disorders, and discontinuing the use of individualized functional assessments for children. Requires the Commissioner of Social Security to redetermine the eligibility of any individual under age 18 who is receiving SSI benefits based on a disability as of the date of the enactment of this Act and whose eligibility for such benefits may terminate by reason of the amendments of this subtitle.

(Sec. 9602) Provides that not less frequently than once every three years the Commissioner shall review the continued SSI eligibility of each individual who has not attained 18 years of age and is eligible for such benefits by reason of an impairment (or combination of impairments) which may improve (or, which is unlikely to improve, at the option of the Commissioner). Requires a parent or guardian of a recipient whose case is so reviewed to present, at the time of review, evidence demonstrating that the recipient is, and has been, receiving treatment, to the extent considered medically necessary and available, of the condition which was the basis for providing benefits under the SSI program.

Provides that if an individual is eligible for SSI benefits by reason of disability for the month preceding the month in which the individual attains age 18, the Commissioner shall redetermine such eligibility: (1) during the one year period beginning on the individual's 18th birthday; and (2) by applying the criteria used in determining the initial eligibility for applicants who have attained age 18.

Specifies requirements governing: (1) continuing disability reviews for low birth weight babies; and (2) benefit payments through representative payees to eligible individuals and their spouses.

(Sec. 9603) Revises representative payee requirements.

(Sec. 9604) Denies SSI by reason of disability to drug addicts and alcoholics for whom the addiction or alcoholism is a contributing factor material to the determination of disability. Provides that, out of any money in the Treasury not otherwise appropriated, the Secretary of the Treasury shall pay to the Director of the National Institute on Drug Abuse specified amounts for expenditure on drug treatment and drug abuse and drug treatment research for FY 1997 through 2000.

(Sec. 9605) Denies SSI benefits for ten years to individuals found to have fraudulently misrepresented residence in order to obtain benefits simultaneously in two or more States.

(Sec. 9606) Denies SSI benefits for fugitive felons and probation and parole violators and provides for exchange of SSI information with law enforcement agencies.

(Sec. 9607) Outlines reapplication requirements for adults receiving SSI benefits by reason of disability. Authorizes appropriations.

(Sec. 9608) Provides for a reduction in the unearned income exclusion under provisions for determining the income of an individual and his eligible spouse under SSI.

Subtitle G: Food Assistance - Chapter 1: Food Stamp Program - Amends the Food Stamp Act of 1977 (Act) to establish food stamp program (program) certification periods of: (1) 24 months for households whose adult members are elderly or disabled; and (2) not more than 12 months for all other households.

Includes energy assistance in household income determinations. Excludes Job Training Partnership Act income from such determinations. Excludes life insurance policies from family resource determinations.

(Sec. 9703) Authorizes the Secretary of Agriculture (Secretary), with regard to retail food stores and wholesale food concerns (stores), to: (1) establish authorization periods for coupon acceptance and redemption; and (2) establish specific time periods for prohibiting program participation of stores based on lack of business integrity.

(Sec. 9705) Includes sales tax information among the types of eligibility verification information which may be requested.

(Sec. 9706) Establishes a six-month reapplication waiting period for a store that does not meet participation requirements.

(Sec. 9708) Authorizes suspension of a store pending administrative and judicial review. (States that the Secretary shall not be liable for lost sales during such period.)

(Sec. 9709) Provides for disqualification of a store that is disqualified from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

(Sec. 9710) Provides for permanent disqualification of a store that knowingly submits a falsified application.

(Sec. 9711) Expands civil and criminal forfeiture for specified violations of the Act.

(Sec. 9712) Amends the Social Security Act as amended by the Social Security Administrative Reform Act of 1994, and the Internal Revenue Code as added to by the Social Security Administrative Reform Act of 1994, to authorize information sharing with State WIC enforcement instrumentalities.

(Sec. 9713) Amends the Act to expand the definition of "coupon."

(Sec. 9714) Increases penalties for specified program violations.

(Sec. 9715) Makes the collection of over-issuance of coupons from Federal pay or Federal tax refunds (as authorized by this section) mandatory.

(Sec. 9716) Encourages and authorizes States to implement electronic benefit transfer systems.

(Sec. 9717) Reduces annual "thrifty food plan" adjustments.

(Sec. 9718) Freezes standard deduction adjustments for two years.

(Sec. 9720) Disqualifies an individual from program participation for: (1) participation in two or more States; and (2) child support arrears.

(Sec. 9722) Authorizes the use of program information to assist in locating fugitive felons.

(Sec. 9723) Defines "work program." Makes nonexempt persons ineligible for program benefits if during the preceding 12-month period they received food stamps for six months or more without working at least 20 hours per week, or participating in a workfare program. Sets forth exempted persons and situations. Revises work requirement and employment and training provisions. Extends employment and training funding authorizations.

(Sec. 9725) Extends current claims retention rates.

(Sec. 9726) Extends Puerto Rico block past assistance.

(Sec. 9727) Treats children who are themselves parents living with their children and married children living with their spouses as part of an existing household rather than as a separate household.

Chapter 2: Commodity Distribution - Commodity Distribution Act of 1995 - Authorizes the Secretary to purchase and distribute food assistance commodities to the States.

(Sec. 9753) Requires the Secretary to establish procedures for supplemental State, local, and private commodity donations.

(Sec. 9754) Requires a State seeking commodity assistance to submit an administrative plan every four years to the Secretary.

(Sec. 9755) Establishes program allocation guidelines. Requires States to make emergency feeding organizations their first priority.

(Sec. 9756) Authorizes the Secretary to use Commodity Credit Corporation (CCC) funds to pay initial commodity processing and packaging costs.

(Sec. 9758) Authorizes program appropriations, including a separate authorization of appropriations for administrative costs.

(Sec. 9760) Obligates specified funds for a commodity supplemental food program for women, infants, and children or the elderly. Requires the CCC to donate specified amounts of cheese and nonfat dry milk to such program.

(Sec. 9761) States that commodities received under this title shall not be considered income or resources for any Federal, State, or local means-tested program.

(Sec. 9768) Repeals the Emergency Food Assistance Act of 1983. Eliminates specified provisions of: (1) the Commodity Distribution Reform Act and WIC Amendments of 1987; (2) the Charitable Assistance and Food Bank Act of 1987; (3) the Food Security Act of 1985; (4) the Agricultural and Consumer Protection Act of 1973; (5) the Food, Agriculture, Conservation, and Trade Act of 1990; and (6) the Hunger Prevention Act of 1988.

Chapter 3: Other Programs - Amends the National School Lunch Act to prohibit an institution with more than one employee from participating in the child and adult care food program if employee payments are based upon the number of day care homes recruited, managed, or monitored.

Revises day care home reimbursement provisions, including sponsor payments.

Obligates specified FY 1996 funds for State grants to family or group day care homes.

Requires specified census data to be provided to day care sponsoring organizations.

(Sec. 9782) Amends the Child Nutrition Act of 1966 to authorize appropriations (current authorization is discretionary) for the nutrition education and training program.

Subtitle H: Treatment of Aliens - Extends the period of sponsor attribution of income and resources (to an alien) under the statewide temporary assistance program (TEA), the supplemental security income program (SSI), and the food stamp program through the date (if any) of such alien's citizenship. Sets forth exceptions based upon age, military or veteran status, family status, domestic violence, or taxpaying status. (Permits Medicaid eligibility.)

Amends the Social Security Act to set forth TEA rules regarding income and resource attribution.

(Sec. 9802) Amends the Immigration and Nationality Act to set forth rules for sponsor affidavits of support.

(Sec. 9803) Extends affidavit of support requirements to family- related and diversity immigrants.

Subtitle I: Earned Income Credit - Amends the Internal Revenue Code to require an individual claiming the earned income tax credit to include the individual's and, if married, the spouse's social security number on the individual's tax return.

Title X: Reductions In Corporate Tax Subsidies and other Reforms - Revenue Reconciliation Act of 1995 - Subtitle A: Tax Treatment of Expatriation - Sets forth the tax responsibilities of: (1) any U.S. citizen who relinquishes his or her U.S. citizenship; or (2) any long-term U.S. resident who commences to be treated as a resident of a foreign country under provisions of a tax treaty and who does not waive the benefits of such treaty applicable to residents of the foreign country. Allows an exclusion from gain of up to $600,000. Permits an expatriate to elect to continue to be taxed as a United States citizen, in which case the provisions applicable to other expatriates will not apply.

Provides for the determination of the basis of the assets of a nonresident alien individual who becomes a U.S. citizen or resident.

Subtitle B: Modification to Earned Income Credit - Amends the Internal Revenue Code to include capital gain net income in the definition of disqualified income for purposes of the denial of the earned income credit for individuals having excessive income.

Subtitle C: Alternative Minimum Tax on Corporations Importing Products into the United States at Artificially Inflated Prices - Imposes an alternative minimum tax on certain corporations equal to four percent of their net business receipts for a taxable year. Imposes such tax on a corporation (foreign or domestic) if: (1) its gross sales in the United States of manufactured parts or products exceeded $10 million; (2) it imported such products with a customs value in excess of $10 million (artificially inflated prices); and (3) its tax obligation under the alternative minimum tax exceeds its total tax obligation.

Subtitle D: Tax Treatment of Certain Extraordinary Dividends - Provides, with respect to a corporate shareholder's basis in stock reduced by the non-tax portion of extraordinary dividends, that if the non-taxed portion of such dividends exceeds such basis, such excess shall be treated as gain from the sale or exchange of such stock for the taxable year in which the extraordinary dividend is received.

Subtitle E: Foreign Trust Tax Compliance - Revises the requirements regarding information that must be reported regarding certain foreign trusts.

Modifies the circumstances (with regard to foreign trusts having one or more U.S. beneficiaries) in which a transferor is treated as the owner.

Replaces provisions setting forth a special rule applicable to foreign grantors with provisions declaring that provisions relating to treating grantors and others as substantial owners shall apply only when that application results in an amount being currently taken into account in computing the income of a U.S. citizen or resident or a domestic corporation.

Requires a United States person to report information regarding foreign gifts or bequests when the gifts' aggregate value during a taxable year exceeds $10,000.

Modifies requirements regarding the interest charge on accumulation distributions from foreign trusts.

Changes the circumstances in which an estate or trust is included in the definition of "United States person." Modifies the definition of "foreign estate or trust." Requires (for provisions relating to the imposition of a tax on transfers to avoid income tax) treating a trust which is not a foreign trust and which becomes a foreign trust as having transferred, immediately before becoming a foreign trust, all of its assets to a foreign trust.

Subtitle F: Limitation on Section 936 Credit - Revises the Puerto Rico and possessions tax credit. Provides for a five year phasedown with respect to such credit.

Title XI: Committee on Veterans' Affairs - Veterans Reconciliation Act of 1995 - Subtitle A: Permanent Extension of Temporary Authorities - Makes permanent the: (1) requirement that non-service disabled veterans having incomes above a specified level make copayments in exchange for hospital and medical care received through the Department of Veterans Affairs; (2) authority of the Department to recover from primary insurers the cost of care furnished to veterans in Department health-care facilities; (3) authority to verify a veteran's income for purposes of eligibility for needs-based benefits; (4) pension payment limitation of $90 monthly to Medicaid-eligible veterans and their surviving spouses who have no dependents and who reside in Medicaid-participating nursing homes; (5) authority of the Secretary of Veterans Affairs to charge and collect a home loan fee for Department-guaranteed housing loans; and (6) procedures applicable upon default of such guaranteed loans.

Subtitle B: Other Matters - Revises the Government's liability standard for injuries or death resulting from Department treatment to allow compensation to be awarded for the additional disability in the same manner as if the disability or death were service-connected. Provides proximate cause requirements.

(Sec. 11022) Extends through FY 1996 (currently, December 31, 1995) the authority of the Secretary to guarantee the real estate mortgage investment conduits used to market pools of veterans' loans.

(Sec. 11023) Authorizes the Department to collect veterans' home loan guaranty debts in the same manner as all other debts arising under Department programs. Requires the Department to provide affected individuals with notice of the procedure for appealing the collection determination.

Subtitle C: Health Care Eligibility Reform - Revises provisions concerning a veteran's eligibility for hospital care and medical services to: (1) allow such care to be provided only to the extent that amounts are provided in advance in appropriations Acts; and (2) provide full eligibility for both hospital and outpatient care for service-disabled veterans, former prisoners of war, veterans of the Mexican border period or World War I, low-income veterans, and veterans who were exposed to a toxic substance, radiation, or an environmental hazard while on active duty.

(Sec. 11032) Extends through December 31, 1998, the authority to provide priority hospital care and medical services for certain Persian Gulf War veterans.

(Sec. 11033) Makes certain veterans eligible for prosthetic devices as long as they are receiving ongoing care through the Department. (Currently, hospitalization is required before such veterans are so eligible.)

(Sec. 11034) Directs the Secretary, in managing the provision of hospital care and medical services, to establish and operate a system of annual patient enrollment, with specified patient priorities. Requires the system to be managed to assure the provision of timely and quality care. Requires the Secretary to establish and manage Department health-care programs in a manner which promotes cost- effective delivery of health care services in the most clinically appropriate setting. Requires the Department to maintain its capacity to provide for specialized needs of certain disabled veterans.

(Sec. 11035) Amends the Veterans Health Care Act of 1992 to repeal a provision which terminates on October 1, 1996, the authority of the Secretary to enter into health care resource sharing agreements with the Department of Defense. Entitles the Unites States to recover from primary insurance providers the cost of care or services provided under such Act through a Department medical facility.

(Sec. 11036) Repeals a statement of congressional purpose with respect to the Department's sharing of specialized medical facilities, equipment, and information. Expands such sharing authority to include all health care resources and to allow health care providers, plans, and insurers, or other entities or individuals to participate in such sharing arrangements. Increases the authorized payment terms with respect to shared resources. (Currently, only reciprocal reimbursement is permitted.) Allows the Secretary to enter into such arrangements for the treatment of non-veterans only in limited circumstances.

(Sec. 11037) Exempts from Department medical personnel ceiling limits all positions held by persons involved in providing health-care resources under sharing arrangements.

Title XII: Legislative Branch - Requires that any unobligated funds following a fiscal year from the official expenses allowance of the House of Representatives be dedicated to the Deficit Reduction Fund.

Title XIII: Miscellaneous Provisions - Eliminates the disparity between the effective dates for the military and civilian retiree cost-of-living adjustments for FY 1996, 1997, and 1998.

Provides for the disposal of specified quantities of the following materials from the National Defense Stockpile: (1) cobalt; (2) aluminum; (3) ferro columbium; (4) germanium; (5) palladium; (6) platinum; and (7) rubber.

Requires that certain executive branch agencies prepay the Government contributions which are or will be required in connection with providing health-benefits coverage for annuitants of such agencies.

Amends the Internal Revenue Code to extend for seven years the Hazardous Substance Superfund Financing Rate and the repayment date for Superfund borrowing.

Title XIV: Budget Process Provisions - Balanced Budget Enforcement Act of 1995 - Establishes a Board of Estimates which shall issue a report stating whether it has chosen the sequestration preview report and final sequestration report of the Office of Management and Budget or the reports of the Congressional Budget Office. Permits the Board to change the list of major estimating assumptions to be used by the Office of Management and Budget and the Congressional Budget Office.

Subtitle B(sic): Discretionary Spending Limits - Amends the Congressional Budget Act of 1974 establish discretionary spending limits for FY 1996 through 2002. Extends congressional committee allocation and enforcement provisions and the applicability of certain points of order through 2002.

Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to revise and extend the budgetary amounts through FY 2000 for the Violent Crime Reduction Trust Fund.

Revises the general statement of budget enforcement to apply to discretionary spending limits and pay-as-you-go requirements rather than expired maximum deficit amounts.

Extends enforcement of discretionary spending limits through FY 2002.

Subtitle C: Pay-As-You-Go Procedures - Permanently extends pay-as-you-go provisions (except for the emergency legislation provision which is repealed) and provides for ten-year scorekeeping.

Subtitle D: Miscellaneous - Repeals effective date provisions of title II of Gramm-Rudman-Hollings.

Subtitle E: Deficit Control - Establishes decreasing deficit targets for FY 1996 through 2002, with a target of zero for each FY after 2002. Sets forth procedures (including sequestration procedures)to be followed if the deficit exceeds the targeted amount for a fiscal year. Lists accounts and activities exempt from sequestration.

Subtitle F: Line Item Veto - Makes provision for line item veto authority, which shall be effective unless disapproved by the passage, as specified, of a rescissions-receipts disapproval bill.

Permits any Member of Congress to seek judicial review of any provision of this subtitle.

Subtitle G: Enforcing Points of Order - Amends Congressional Budget Act of 1974 provisions concerning points of order in the Senate and House of Representatives.

Subtitle H: Deficit Reduction Lock-box - Requires any appropriation bill being marked up or reported to contain a line item entitled "Deficit Reduction Lock-box". Specifies amounts which shall comprise such line in any reported: (1) general appropriations bill containing Treasury and Postal Service appropriations; (2) general appropriations bill; or (3) supplemental appropriations bill. Provides for the reduction of the discretionary spending limit for new budget authority by the amount of budget authority transferred to the Deficit Reduction Lock-box. Requires the Congressional Budget Office scorecard to include amounts contained in the Deficit Reduction Lock-box.

Subtitle I: Emergency Spending; Baseline Reform; Continuing Resolutions Reform - Chapter 1: Emergency Spending - Provides for the establishment of a budget reserve account for the purpose of setting aside adequate funding for natural disasters and national security measures. Set forth provisions concerning: (1) points of order regarding emergencies; (2)congressional budget process changes; and (3) reporting.

Chapter 2: Baseline Reform - Provides, when making baseline assumptions, for adjustments: (1) for inflation, only to adjust discretionary spending limits; and (2) to offset pay absorption and for pay annualization, only to adjust discretionary spending limits.

Requires the President's budget to include estimated expenditures and appropriations for the current fiscal year.

Requires the starting point for any congressional budget deliberations for the next fiscal year to be the estimated level of outlays for the current year in each function and subfunction.

Chapter 3: Restricted Uses of Continuing Resolutions - Amends the Rules of the House of Representatives to: (1) prohibit any item of appropriation set forth in any joint resolution continuing appropriations, or amendment thereto, from exceeding the rate it would have been at assuming the continuation of current law; and (2) prohibit it being in order to consider any joint resolution continuing appropriations, or amendment thereto, which changes existing law.

Subtitle J: Technical and Conforming Amendments - Makes technical and conforming amendments to: (1) the Congressional Budget and Impoundment Control Act of 1974; (2) the Rules of the House of Representatives; and (3) provisions concerning the President's budget.

Subtitle K: Truth in Legislating - Requires the report or joint explanatory statement accompanying each House of Representatives reported bill or resolution of a public character to: (1) identify each provision benefitting ten or fewer persons, corporations, organizations, projects, or civil subdivisions; (2) name each beneficiary; (3) name sponsors; and (4) contain a cost estimate.