(Sec. 101) Authorizes appropriations.
(Sec. 102) Expresses the sense of Congress that: (1) the Health Care Financing Administration (HCFA) encourage inclusion of preventive health measures in all Medicare treatments; (2) HCFA expand the study of the most promising behavioral modification of risk factors associated with health promotion and disease prevention for all Medicare beneficiaries; and (3) the National Library of Medicine establish a Medicare health promotion and disease prevention intervention clearinghouse.
Title II: Medicare Coverage of Preventive Services - Amends title XVIII (Medicare) of the Social Security Act (SSA) to outline Medicare coverage of various specified preventive services, including: (1) counseling for cessation of tobacco use; (2) screening for hypertension; (3) counseling for hormone replacement therapy; (4) screening for glaucoma and for diminished visual acuity; and (5) screening and counseling for osteoporosis.
(Sec. 209) Waives coinsurance and deductibles for certain preventive services, such as: (1) diabetes outpatient self-management training services; (2) colorectal and prostate cancer screening tests; and (3) bone mass measurement.
(Sec. 210) Directs the Secretary to conduct a national falls prevention and awareness campaign to reduce fall-related injuries among Medicare beneficiaries and to integrate specified preventive benefits added by this Act with existing program integrity measures.
Title III: Medicare Health Education and Risk Appraisal Program - Amends SSA title XVIII to direct the HHS Secretary to: (1) establish a health education and risk appraisal program to inform certain target individuals, including Medicare beneficiaries, of described major behavioral risk factors through self-assessment; and (2) conduct periodic followups.
Title IV: Disease Self-Management Demonstration Projects - Establishes in HHS a Disease Self-Management Working Group. Directs the HHS Secretary to conduct demonstration projects to promote disease self-management for conditions identified by the Group for described target individuals. Provides funding.
Title V: Studies and Reports Advancing Original Research in the Field of Disease Prevention and the Elderly - Amends SSA title XVIII to revise reporting requirements for the Medicare Payment Advisory Commission.
(Sec. 502) Directs the Director of the National Institutes on Aging to conduct one or more studies, for associated reports to the HHS Secretary and the Institute of Medicine of the National Academy of Sciences, that focus on ways to: (1) improve quality of life for the elderly; (2) develop better ways to prevent or delay the onset of age-related functional decline and disease and disability among the elderly; and (3) develop means of assessing the long-term development of cost-effective benefits and cost-saving benefits for health promotion and disease prevention among the elderly. Authorizes appropriations.
(Sec. 503) Directs the HHS Secretary to contract with the Institute to study and report to the President and Congress on health promotion and disease prevention among Medicare beneficiaries.
(Sec. 504) Provides for fast-track consideration of prevention benefit legislation in the House of Representatives and in the Senate.
[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 1618 Introduced in Senate (IS)]
106th CONGRESS
1st Session
S. 1618
To promote primary and secondary health promotion and disease
prevention services and activities among the elderly, to amend title
XVIII of the Social Security Act to add preventive benefits, and for
other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
September 22, 1999
Mr. Graham (for himself, Mr. Jeffords, Mr. Chafee, Mr. Bryan, Mr.
Rockefeller, and Mr. Kerry) introduced the following bill; which was
read twice and referred to the Committee on Finance
_______________________________________________________________________
A BILL
To promote primary and secondary health promotion and disease
prevention services and activities among the elderly, to amend title
XVIII of the Social Security Act to add preventive benefits, and for
other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Medicare Wellness
Act of 1999''.
(b) Table of Contents.--The table of contents is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Finding.
Sec. 3. Definitions.
TITLE I--HEALTHY SENIORS PROMOTION PROGRAM
Sec. 101. Healthy Seniors Promotion Program.
Sec. 102. Sense of Congress regarding the response of HCFA to
preventive health issues.
Sec. 103. Sense of Congress regarding the efforts of HCFA to study
health promotion and disease prevention for
medicare beneficiaries.
Sec. 104. Sense of Congress regarding the establishment of a medicare
health promotion and disease prevention
clearinghouse.
TITLE II--MEDICARE COVERAGE OF PREVENTIVE SERVICES
Sec. 201. Counseling for cessation of tobacco use.
Sec. 202. Screening for hypertension.
Sec. 203. Counseling for hormone replacement therapy.
Sec. 204. Screening for glaucoma.
Sec. 205. Screening for diminished visual acuity.
Sec. 206. Screening for hearing impairment.
Sec. 207. Screening and counseling for osteoporosis.
Sec. 208. Screening for cholesterol.
Sec. 209. Elimination of cost sharing for current preventive benefits.
Sec. 210. National falls prevention education and awareness campaign.
Sec. 211. Program integrity.
TITLE III--MEDICARE HEALTH EDUCATION AND RISK APPRAISAL PROGRAM
Sec. 301. Medicare Health Education and Risk Appraisal Program.
TITLE IV--DISEASE SELF-MANAGEMENT DEMONSTRATION PROJECTS
Sec. 401. Disease self-management demonstration projects.
TITLE V--STUDIES AND REPORTS ADVANCING ORIGINAL RESEARCH IN THE FIELD
OF DISEASE PREVENTION AND THE ELDERLY
Sec. 501. MedPAC biannual report.
Sec. 502. National Institute on Aging study and report.
Sec. 503. Institute of Medicine 5-year medicare prevention benefit
study and report.
Sec. 504. Fast-track consideration of prevention benefit legislation.
SEC. 2. FINDING.
Congress finds that despite significant advancements in general
research for health promotion and disease prevention among the elderly,
there has been a failure in translating that research into practical
intervention.
SEC. 3. DEFINITIONS.
As used in this Act:
(1) Cost-effective benefit.--The term ``cost-effective
benefit'' means a benefit or technique that has--
(A) been subject to peer review;
(B) been described in scientific journals; and
(C) demonstrated value as measured by unit costs
relative to health outcomes achieved.
(2) Cost-saving benefit.--The term ``cost-saving benefit''
means a benefit or technique that has--
(A) been subject to peer review;
(B) been described in scientific journals; and
(C) caused a net reduction in health care costs for
medicare beneficiaries.
(3) Medically effective.--The term ``medically effective''
means, with respect to a benefit or technique, that the benefit
or technique has been--
(A) subject to peer review;
(B) described in scientific journals; and
(C) determined to achieve an intended goal under
normal, programmatic conditions.
(4) Medical efficacy; medically efficacious.--The terms
``medical efficacy'' and ``medically efficacious'' mean, with
respect to a benefit or technique, that the benefit or
technique has been--
(A) subject to peer review;
(B) described in scientific journals; and
(C) determined to achieve an intended goal under
controlled conditions.
(5) Medicare beneficiary.--The term ``medicare
beneficiary'' means any individual who is entitled to benefits
under part A or enrolled under part B of the medicare program,
including any individual enrolled in a Medicare+Choice plan
offered by a Medicare+Choice organization under part C of such
program.
(6) Medicare program.--The term ``medicare program'' means
the health care program under title XVIII of the Social
Security Act (42 U.S.C. 1395 et seq.).
(7) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
TITLE I--HEALTHY SENIORS PROMOTION PROGRAM
SEC. 101. HEALTHY SENIORS PROMOTION PROGRAM.
(a) Definitions.--As used in this section:
(1) Eligible entity.--The term ``eligible entity'' means an
entity that the Working Group determines has demonstrated
expertise in research regarding health promotion and disease
prevention among the elderly.
(2) Working group.--The term ``Working Group'' means the
Healthy Seniors Working Group established under subsection (d).
(b) Program Authorized.--The Secretary, subject to the general
policies and criteria established by the Working Group and in
accordance with the provisions of this Act, is authorized to make
grants to eligible entities to pay for the costs of the activities
described in subsection (c).
(c) Use of Funds.--An eligible entity may use payments received
under this section in any fiscal year to study--
(1) whether using different types of providers of care who
are not physicians and alternative settings (including
community-based senior centers) for the implementation of a
successful health promotion and disease prevention strategy,
including the implications regarding the payment of such
providers, is medically efficacious or medically effective;
(2) the most medically effective means of educating
medicare beneficiaries and providers of services regarding the
importance of health promotion and disease prevention among the
elderly and identification of incentives that would increase
the use of new and existing preventive services and healthy
behaviors by medicare beneficiaries; and
(3) other topics designated by the Secretary.
(d) Healthy Seniors Working Group.--
(1) Establishment.--There is established within the
Department of Health and Human Services a Healthy Seniors
Working Group.
(2) Composition.--Subject to paragraph (3), the Working
Group established pursuant to subsection (b) shall be composed
of 5 members as follows:
(A) The Administrator of the Health Care Financing
Administration.
(B) The Director of the Centers for Disease Control
and Prevention.
(C) The Administrator of the Agency for Health Care
Policy and Research.
(D) The Assistant Secretary for Aging.
(E) The Director of the National Institute on
Aging.
(3) Alternative membership.--
(A) Appointment.--Any member of the Working Group
described in a subparagraph of paragraph (2) may
appoint an individual who is an officer or employee of
the Federal Government to serve as a member of the
Working Group instead of the member described in such
subparagraph.
(B) Deadline.--If a member described in
subparagraph (A) elects to appoint an individual under
such subparagraph, such individual shall be appointed
not later than December 31, 2000.
(4) General policies and criteria.--The Working Group shall
establish general policies and criteria with respect to the
functions of the Secretary under this section including--
(A) priorities for the approval of applications;
(B) procedures for developing, monitoring, and
evaluating research efforts conducted under this
section; and
(C) such other matters as are recommended by the
Working Group and approved by the Secretary.
(5) Chairperson.--The Chairperson of the Working Group
shall be the Administrator of the Agency for Health Care Policy
and Research.
(6) Quorum.--A majority of the members of the Working Group
shall constitute a quorum, but a lesser number of members may
hold hearings.
(7) Meetings.--The Working Group shall meet at the call of
the Chairperson, except that--
(A) it shall meet not less than 4 times each year;
and
(B) it shall meet whenever a majority of the
appointed members request a meeting in writing.
(8) Compensation of members.--Each member of the Working
Group shall be an officer or employee of the Federal Government
and shall serve without compensation in addition to that
received for their service as an officer or employee of the
Federal Government.
(e) Application.--
(1) In general.--Each eligible entity which desires to
receive a grant under this section shall submit an application
to the Secretary, at such time, in such manner, and accompanied
by such additional information as the Secretary may reasonably
require.
(2) Contents.--Each application submitted pursuant to
paragraph (1) shall--
(A) describe the activities for which assistance
under this section is sought;
(B) describe how the research effort proposed to be
conducted will reflect the medical, behavioral, and
social aspects of care for the elderly, lead to the
development of cost-effective benefits and cost-saving
benefits, and impact the quality of life of medicare
beneficiaries;
(C) provide evidence that the eligible entity meets
the general policies established by the Working Group
pursuant to subsection (d)(4);
(D) provide assurances that the eligible entity
will take such steps as may be available to it to
continue the activities for which the eligible entity
is making application after the period for which
assistance is sought; and
(E) provide such additional assurances as the
Secretary determines to be essential to ensure
compliance with the requirements of this Act.
(3) Joint application.--A consortium of eligible entities
may file a joint application under the provisions of paragraph
(1) of this subsection.
(f) Approval of Application.--The Secretary shall approve
applications in accordance with the general policies established by the
Working Group under subsection (d).
(g) Payments.--The Secretary shall pay to each eligible entity
having an application approved under subsection (f) the cost of the
activities described in the application.
(h) Evaluation and Report.--
(1) Evaluation.--The Secretary shall conduct an annual
evaluation of grants made under this section to determine--
(A) the results of the overall applied research
conducted under this Act;
(B) the extent to which research assisted under
this section has improved or expanded the general
research for health promotion and disease prevention
among the elderly and identified practical
interventions based upon such research;
(C) a list of specific recommendations based upon
research conducted under this section which show
promise as practical interventions for health promotion
and disease prevention among the elderly;
(D) whether or not as a result of the applied
research effort certain health promotion and disease
prevention benefits or education efforts should be
added to the medicare program, including discussions of
quality of life, translating the applied research
results into a benefit under the medicare program, and
whether each additional benefit would be a cost-
effective benefit or cost-saving benefit for each
proposed addition;
(E) the utility of, potential for, and issues
surrounding health risk appraisals sponsored under the
medicare program and targeted followup; and
(F) how best to increase utilization of existing
and recommended health promotion and disease prevention
services, including an education and public awareness
component discussion of financial incentives for
providers of services and medicare beneficiaries to
improve utilization and other administrative means of
increasing utilization.
(2) Annual report.--Not later than December 31, 2002, and
each year thereafter through 2005, the Secretary shall submit a
report to Congress based on the annual studies made under
paragraph (1), which shall contain a detailed statement of the
findings and conclusions of the Working Group together with its
recommendations for such legislation and administrative actions
as it considers appropriate.
(i) Authorization of Appropriations.--There are authorized to be
appropriated $40,000,000 for each of the fiscal years 2000, 2001, 2002,
and 2003 to carry out the provisions of this section.
SEC. 102. SENSE OF CONGRESS REGARDING THE RESPONSE OF HCFA TO
PREVENTIVE HEALTH ISSUES.
It is the sense of Congress that in administering the medicare
program the Secretary should ensure that the Administrator of the
Health Care Financing Administration encourages the inclusion of
preventive measures as part of all treatments described in such
program.
SEC. 103. SENSE OF CONGRESS REGARDING THE EFFORTS OF HCFA TO STUDY
HEALTH PROMOTION AND DISEASE PREVENTION FOR MEDICARE
BENEFICIARIES.
It is the sense of Congress that the Secretary should ensure that
the Administrator of the Health Care Financing Administration expands
the study of the most promising behavioral modification of risk factors
associated with health promotion and disease prevention for all
medicare beneficiaries.
SEC. 104. SENSE OF CONGRESS REGARDING THE ESTABLISHMENT OF A MEDICARE
HEALTH PROMOTION AND DISEASE PREVENTION CLEARINGHOUSE.
It is the sense of Congress that the National Library of Medicine
should collect information regarding innovative and successful health
promotion and disease prevention interventions from both published and
unpublished sources, establish a clearinghouse targeting all medicare
beneficiaries in a variety of settings for the consolidation and
coordination of all such information, and make the clearinghouse
available to the public and accessible through the Internet.
TITLE II--MEDICARE COVERAGE OF PREVENTIVE SERVICES
SEC. 201. COUNSELING FOR CESSATION OF TOBACCO USE.
(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) is amended--
(1) in subparagraph (S), by striking ``and'' at the end;
(2) in subparagraph (T), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(U) counseling for cessation of tobacco use (as defined
in subsection (uu)) for individuals who have a history of
tobacco use.''.
(b) Services Described.--Section 1861 of such Act (42 U.S.C. 1395x)
is amended by adding at the end the following:
``Counseling for Cessation of Tobacco Use
``(uu)(1) Except as provided in paragraph (2), the term `counseling
for cessation of tobacco use' means diagnostic, therapy, and counseling
services for cessation of tobacco use which are furnished by or under
the supervision of a physician or other health care professional who is
legally authorized to furnish such services under State law (or the
State regulatory mechanism provided by State law) of the State in which
the services are furnished, as would otherwise be covered if furnished
by a physician or as an incident to a physician's professional service.
``(2) The term `counseling for cessation of tobacco use' does not
include coverage for drugs or biologicals that are not otherwise
covered under this title.''.
(c) Elimination of Cost Sharing.--
(1) Elimination of coinsurance.--Section 1833(a)(1) of such
Act (42 U.S.C. 1395l(a)(1)) is amended--
(A) by striking ``and (S)'' and inserting ``(S)'';
and
(B) by striking the semicolon at the end and
inserting the following: ``, and (T) with respect to
counseling for cessation of tobacco use (as defined in
section 1861(uu)), the amount paid shall be 100 percent
of the lesser of the actual charge for the services or
the amount determined by a fee schedule established by
the Secretary for the purposes of this subparagraph;''.
(2) Elimination of deductible.--The first sentence of
section 1833(b) of such Act (42 U.S.C. 1395l(b)) is amended--
(A) by striking ``and'' before ``(6)''; and
(B) by inserting before the period the following:
``, and (7) such deductible shall not apply with
respect to counseling for cessation of tobacco use (as
defined in section 1861(uu))''.
(d) Effective Date.--The amendments made by this section shall
apply to services furnished on or after December 31, 2001.
SEC. 202. SCREENING FOR HYPERTENSION.
(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) (as amended by section 201(a)) is amended--
(1) in subparagraph (T), by striking ``and'' at the end;
(2) in subparagraph (U), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(V) screening for hypertension (as defined in subsection
(vv)) not more frequently than once every 2 years for
individuals with normotensive blood pressure measurements and
annually for individuals with blood pressure measurements that
are not normotensive.''.
(b) Services Described.--Section 1861 of such Act (42 U.S.C. 1395x)
(as amended by section 201(b)) is amended by adding at the end the
following:
``Screening for Hypertension
``(vv) The term `screening for hypertension' means diagnostic
services for hypertension which are furnished by or under the
supervision of a physician or other health care professional who is
legally authorized to furnish such services under State law (or the
State regulatory mechanism provided by State law) of the State in which
the services are furnished, as would otherwise be covered if furnished
by a physician or as an incident to a physician's professional
service.''.
(c) Elimination of Cost Sharing.--
(1) Elimination of coinsurance.--Section 1833(a)(1) of such
Act (42 U.S.C. 1395l(a)(1)) (as amended by section 201(c)(1))
is amended--
(A) by striking ``and (T)'' and inserting ``(T)'';
and
(B) by striking the semicolon at the end and
inserting the following: ``, and (U) with respect to
screening for hypertension (as defined in section
1861(vv)), the amount paid shall be 100 percent of the
lesser of the actual charge for the services or the
amount determined by a fee schedule established by the
Secretary for the purposes of this subparagraph;''.
(2) Elimination of deductible.--The first sentence of
section 1833(b) of such Act (42 U.S.C. 1395l(b)) (as amended by
section 201(c)(2)) is amended--
(A) by striking ``and'' before ``(7)''; and
(B) by inserting before the period the following:
``, and (8) such deductible shall not apply with
respect to screening for hypertension (as defined in
section 1861(vv))''.
(d) Effective Date.--The amendments made by this section shall
apply to services furnished on or after December 31, 2001.
SEC. 203. COUNSELING FOR HORMONE REPLACEMENT THERAPY.
(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) (as amended by section 202(a)) is amended--
(1) in subparagraph (U), by striking ``and'' at the end;
(2) in subparagraph (V), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(W) counseling for hormone replacement therapy (as
defined in subsection (ww)).''.
(b) Services Described.--Section 1861 of such Act (42 U.S.C. 1395x)
(as amended by section 202(b)) is amended by adding at the end the
following:
``Counseling for Hormone Replacement Therapy
``(ww)(1) Except as provided in paragraph (2), the term `counseling
for hormone replacement therapy' means diagnostic, therapy, and
counseling services for hormone replacement which are furnished by or
under the supervision of a physician or other health care professional
who is legally authorized to furnish such services under State law (or
the State regulatory mechanism provided by State law) of the State in
which the services are furnished, as would otherwise be covered if
furnished by a physician or as an incident to a physician's
professional service.
``(2) The term `counseling for hormone replacement therapy' does
not include coverage for drugs or biologicals that are not otherwise
covered under this title.''.
(c) Elimination of Cost Sharing.--
(1) Elimination of coinsurance.--Section 1833(a)(1) of such
Act (42 U.S.C. 1395l(a)(1)) (as amended by section 202(c)(1))
is amended--
(A) by striking ``and (U)'' and inserting ``(U)'';
and
(B) by striking the semicolon at the end and
inserting the following: ``, and (V) with respect to
counseling for hormone replacement therapy (as defined
in section 1861(ww)), the amount paid shall be 100
percent of the lesser of the actual charge for the
services or the amount determined by a fee schedule
established by the Secretary for the purposes of this
subparagraph;''.
(2) Elimination of deductible.--The first sentence of
section 1833(b) of such Act (42 U.S.C. 1395l(b)) (as amended by
section 202(c)(2)) is amended--
(A) by striking ``and'' before ``(8)''; and
(B) by inserting before the period the following:
``, and (9) such deductible shall not apply with
respect to counseling for hormone replacement therapy
(as defined in section 1861(ww))''.
(d) Effective Date.--The amendments made by this section shall
apply to services furnished on or after December 31, 2001.
SEC. 204. SCREENING FOR GLAUCOMA.
(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) (as amended by section 203(a)) is amended--
(1) in subparagraph (V), by striking ``and'' at the end;
(2) in subparagraph (W), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(X) screening for glaucoma (as defined in subsection
(xx)) for individuals determined to be at high risk for
glaucoma, individuals with a family history of glaucoma, and
individuals with diabetes or myopia.''.
(b) Services Described.--Section 1861 of such Act (42 U.S.C. 1395x)
(as amended by section 203(b)) is amended by adding at the end the
following:
``Screening for Glaucoma
``(xx) The term `screening for glaucoma' means a dilated eye
examination with an intraocular pressure measurement, and a direct
ophthalmoscopy or a slit-lamp biomicroscopic examination for the early
detection of glaucoma which is furnished by or under the supervision of
an optometrist or ophthalmologist who is legally authorized to furnish
such services under State law (or the State regulatory mechanism
provided by State law) of the State in which the services are
furnished, as would otherwise be covered if furnished by a physician or
as an incident to a physician's professional service.''.
(c) Elimination of Cost Sharing.--
(1) Elimination of coinsurance.--Section 1833(a)(1) of such
Act (42 U.S.C. 1395l(a)(1)) (as amended by section 203(c)(1))
is amended--
(A) by striking ``and (V)'' and inserting ``(V)'';
and
(B) by striking the semicolon at the end and
inserting the following: ``, and (W) with respect to
screening for glaucoma (as defined in section
1861(xx)), the amount paid shall be 100 percent of the
lesser of the actual charge for the services or amount
determined by a fee schedule established by the
Secretary for the purposes of this subparagraph;''.
(2) Elimination of deductible.--The first sentence of
section 1833(b) of such Act (42 U.S.C. 1395l(b)) (as amended by
section 203(c)(2)) is amended--
(A) by striking ``and'' before ``(9)''; and
(B) by inserting before the period the following:
``, and (10) such deductible shall not apply with
respect to screening for glaucoma (as defined in
section 1861(xx))''.
(d) Effective Date.--The amendments made by this section shall
apply to services furnished on or after December 31, 2001.
SEC. 205. SCREENING FOR DIMINISHED VISUAL ACUITY.
(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) (as amended by section 204(a)) is amended--
(1) in subparagraph (W), by striking ``and'' at the end;
(2) in subparagraph (X), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(Y) screening for diminished visual acuity (as defined in
subsection (yy)).''.
(b) Services Described.--Section 1861 of such Act (42 U.S.C. 1395x)
(as amended by section 204(b)) is amended by adding at the end the
following:
``Screening for Diminished Visual Acuity
``(yy) The term `screening for diminished visual acuity' means
diagnostic services for screening for diminished visual acuity which
are furnished by or under the supervision of an optometrist or
ophthalmologist who is legally authorized to furnish such services
under State law (or the State regulatory mechanism provided by State
law) of the State in which the services are furnished, as
would otherwise be covered if furnished by a physician or as an
incident to a physician's professional service.''.
(c) Elimination of Cost Sharing.--
(1) Elimination of coinsurance.--Section 1833(a)(1) of such
Act (42 U.S.C. 1395l(a)(1)) (as amended by section 204(c)(1))
is amended--
(A) by striking ``and (W)'' and inserting ``(W)'';
and
(B) by striking the semicolon at the end and
inserting the following: ``, and (X) with respect to
screening for diminished visual acuity (as defined in
section 1861(yy)), the amount paid shall be 100 percent
of the lesser of the actual charge for the services or
the amount determined by a fee schedule established by
the Secretary for the purposes of this subparagraph;''.
(2) Elimination of deductible.--The first sentence of
section 1833(b) of such Act (42 U.S.C. 1395l(b)) (as amended by
section 204(c)(2)) is amended--
(A) by striking ``and'' before ``(10)''; and
(B) by inserting before the period the following:
``, and (11) such deductible shall not apply with
respect to screening for diminished visual acuity (as
defined in section 1861(yy))''.
(d) Effective Date.--The amendments made by this section shall
apply to services furnished on or after December 31, 2001.
SEC. 206. SCREENING FOR HEARING IMPAIRMENT.
(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) (as amended by section 205(a)) is amended--
(1) in subparagraph (X), by striking ``and'' at the end;
(2) in subparagraph (Y), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(Z) screening for hearing impairment (as defined in
subsection (zz)).''.
(b) Services Described.--Section 1861 of such Act (42 U.S.C. 1395x)
(as amended by section 205(b)) is amended by adding at the end the
following:
``Screening for Hearing Impairment
``(zz) The term `screening for hearing impairment' means diagnostic
services for hearing impairment by use of periodic questions, otoscopic
examination and audio metric testing if such questions indicate
potential hearing impairment, and counseling about hearing aid devices
which are furnished by or under the supervision of a physician or other
health care professional who is legally authorized to furnish such
services under State law (or the State regulatory mechanism provided by
State law) of the State in which the services are furnished, as would
otherwise be covered if furnished by a physician or as an incident to a
physician's professional service.''.
(c) Elimination of Cost Sharing.--
(1) Elimination of coinsurance.--Section 1833(a)(1) of such
Act (42 U.S.C. 1395l(a)(1)) (as amended by section 205(c)(1))
is amended--
(A) by striking ``and (X)'' and inserting ``(X)'';
and
(B) by striking the semicolon at the end and
inserting the following: ``, and (Y) with respect to
screening for hearing impairment (as defined in section
1861(zz)), the amount paid shall be 100 percent of the
lesser of the actual charge for the services or the
amount determined by a fee schedule established by the
Secretary for the purposes of this subparagraph;''.
(2) Elimination of deductible.--The first sentence of
section 1833(b) of such Act (42 U.S.C. 1395l(b)) (as amended by
section 205(c)(2)) is amended--
(A) by striking ``and'' before ``(11)''; and
(B) by inserting before the period the following:
``, and (12) such deductible shall not apply with
respect to screening for hearing impairment (as defined
in section 1861(zz))''.
(d) Effective Date.--The amendments made by this section shall
apply to services furnished on or after December 31, 2001.
SEC. 207. SCREENING AND COUNSELING FOR OSTEOPOROSIS.
(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) (as amended by section 206(a)) is amended--
(1) in subparagraph (Y), by striking ``and'' at the end;
(2) in subparagraph (Z), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(AA) screening and counseling for osteoporosis (as
defined in subsection (aaa)) for--
``(i) women; and
``(ii) men with fractures.''.
(b) Services Described.--Section 1861 of such Act (42 U.S.C. 1395x)
(as amended by section 206(b)) is amended by adding at the end the
following:
``Screening and counseling for Osteoporosis
``(aaa) The term `screening and counseling for osteoporosis' means
diagnostic and counseling services for osteoporosis in addition to a
bone mass measurement (as defined in subsection (rr)) which are
furnished in accordance with methods approved by the Food and Drug
Administration by or under the supervision of a physician or other
health care professional who is legally authorized to furnish such
services under State law (or the State regulatory mechanism provided by
State law) of the State in which the services are furnished, as would
otherwise be covered if furnished by a physician or as an incident to a
physician's professional service.''.
(c) Elimination of Cost Sharing.--
(1) Elimination of coinsurance.--Section 1833(a)(1) of such
Act (42 U.S.C. 1395l(a)(1)) (as amended by section 206(c)(1))
is amended--
(A) by striking ``and (Y)'' and inserting ``(Y)'';
and
(B) by striking the semicolon at the end and
inserting the following: ``, and (Z) with respect to
screening and counseling for osteoporosis (as defined
in section 1861(aaa)), the amount paid shall be 100
percent of the lesser of the actual charge for the
services or the amount determined by a fee schedule
established by the Secretary for the purposes of this subparagraph;''.
(2) Elimination of deductible.--The first sentence of
section 1833(b) of such Act (42 U.S.C. 1395l(b)) (as amended by
section 206(c)(2)) is amended--
(A) by striking ``and'' before ``(12)''; and
(B) by inserting before the period the following:
``, and (13) such deductible shall not apply with
respect to screening and counseling for osteoporosis
(as defined in section 1861(aaa))''.
(d) Effective Date.--The amendments made by this section shall
apply to services furnished on or after December 31, 2001.
SEC. 208. SCREENING FOR CHOLESTEROL.
(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) (as amended by section 207(a)) is amended--
(1) in subparagraph (Z), by striking ``and'' at the end;
(2) in subparagraph (AA), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(BB) screening for cholesterol (as defined in subsection
(bbb)) for individuals between the ages of 65 and 75 that
exhibit major risk factors for coronary heart disease,
including smoking, hypertension, and diabetes.''.
(b) Services Described.--Section 1861 of such Act (42 U.S.C. 1395x)
(as amended by section 207(b)) is amended by adding at the end the
following:
``Screening for Cholesterol
``(bbb) The term `screening for cholesterol' means diagnostic
services for cholesterol that are furnished by or under the supervision
of a physician or other health care professional who is legally
authorized to furnish such services under State law (or the State
regulatory mechanism provided by State law) of the State in which the
services are furnished, as would otherwise be covered if furnished by a
physician or as an incident to a physician's professional service.''.
(c) Elimination of Cost Sharing.--
(1) Elimination of coinsurance.--Section 1833(a)(1) of such
Act (42 U.S.C. 1395l(a)(1)) (as amended by section 207(c)(1))
is amended--
(A) by striking ``and (Z)'' and inserting ``(Z)'';
and
(B) by striking the semicolon at the end and
inserting the following: ``, and (AA) with respect to
screening for cholesterol (as defined in section
1861(bbb)), the amount paid shall be 100 percent of the
lesser of the actual charge for the services or the
amount determined by a fee schedule established by the
Secretary for the purposes of this subparagraph;''.
(2) Elimination of deductible.--The first sentence of
section 1833(b) of such Act (42 U.S.C. 1395l(b)) (as amended by
section 207(c)(2)) is amended--
(A) by striking ``and'' before ``(13)''; and
(B) by inserting before the period the following:
``, and (14) such deductible shall not apply with
respect to screening and counseling for osteoporosis
(as defined in section 1861(bbb))''.
(d) Effective Date.--The amendments made by this section shall
apply to services furnished on or after December 31, 2001.
SEC. 209. ELIMINATION OF COST SHARING FOR CURRENT PREVENTIVE BENEFITS.
(a) Waiver of Coinsurance and Deductibles.--
(1) In general.--Section 1834 of the Social Security Act
(42 U.S.C. 1395m) is amended by adding at the end the
following:
``(m) Waiver of Coinsurance and Deductible for Preventive
Services.--
``(1) Coinsurance.--
``(A) In general.--Notwithstanding any other
provision of this part--
``(i) the Secretary shall waive any
coinsurance applicable to services described in
subparagraph (B); and
``(ii) with respect to payment for such
services, any reference to a percent that is
less than 100 percent shall be deemed to be a
reference to 100 percent.
``(B) Services described.--The services described
in this subparagraph are the following services:
``(i) Screening mammography (as defined in
section 1861(jj)).
``(ii) Screening pelvic exam (as defined in
section 1861(nn)(2)).
``(iii) Hepatitis B vaccine and its
administration (under section 1861(s)(10)(B)).
``(iv) Colorectal cancer screening test (as
defined in section 1861(pp)).
``(v) Bone mass measurement (as defined in
section 1861(rr)).
``(vi) Prostate cancer screening test (as
defined in section 1861(oo)).
``(vii) Diabetes outpatient self-management
training services (as defined in section
1861(qq)).
``(2) Deductible.--
``(A) In general.--Notwithstanding any other
provision of this part, the deductible described in
section 1833(b) shall not apply with respect to
services described in subparagraph (B).
``(B) Services described.--The services described
in this subparagraph are the following services:
``(i) Hepatitis B vaccine and its
administration (under section 1861(s)(10)(B)).
``(ii) Colorectal cancer screening test (as
defined in section 1861(pp)).
``(iii) Bone mass measurement (as defined
in section 1861(rr)).
``(iv) Prostate cancer screening test (as
defined in section 1861(oo)).
``(v) Diabetes outpatient self-management
training services (as defined in section
1861(qq)).''.
(2) Conforming amendment.--Section 1833(a) of the Social
Security Act (42 U.S.C. 1395l(a)) is amended by striking
``section 1876'' and inserting ``sections 1834 and 1876'' in
the matter preceding paragraph (1).
(b) Effective Date.--The amendments made by this section shall
apply to services furnished on or after December 31, 2001.
SEC. 210. NATIONAL FALLS PREVENTION EDUCATION AND AWARENESS CAMPAIGN.
The Secretary, in consultation with the Director of the Centers for
Disease Control and Prevention, shall conduct a national falls
prevention and awareness campaign to reduce fall-related injuries among
medicare beneficiaries.
SEC. 211. PROGRAM INTEGRITY.
The Secretary, in consultation with the Inspector General of the
Department of Health and Human Services, shall integrate the benefits
described in sections 201 through 208 with existing program integrity
measures.
TITLE III--MEDICARE HEALTH EDUCATION AND RISK APPRAISAL PROGRAM
SEC. 301. MEDICARE HEALTH EDUCATION AND RISK APPRAISAL PROGRAM.
(a) In General.--Title XVIII of the Social Security Act (42 U.S.C.
1395 et seq.) is amended by adding at the end the following:
``medicare health education and risk appraisal program
``Sec. 1897. (a) Establishment.--The Secretary, in consultation
with the Director of the Centers for Disease Control and Prevention,
the Administrator of the Agency for Health Care Policy and Research,
and the Administrator of the Health Care Financing Administration,
shall establish a health education and risk appraisal program to inform
the target individuals described in subsection (b) of the major
behavioral risk factors described in subsection (c) through the self-
assessment described in subsection (d) and shall conduct the periodic
followup described in subsection (e).
``(b) Target Individuals.--The target individuals described in this
subsection are the following:
``(1) Medicare beneficiaries.--Individuals that are
beneficiaries under this title.
``(2) Individuals between the ages of 50 and 64.--
Individuals between the ages of 50 and 64.
``(c) Major Behavioral Risk Factors.--The major behavioral risk
factors described in this subsection include--
``(1) the lack of proper nutrition;
``(2) the use of alcohol;
``(3) the lack of regular exercise;
``(4) the use of tobacco;
``(5) depression; and
``(6) other risk factors identified by the Secretary.
``(d) Self-Assessment.--
``(1) In general.--The self-assessment described in this
subsection is a form delivered by the Secretary to each target
individual that--
``(A) includes questions regarding major behavioral
risk factors;
``(B) requests that such individual answer the
questions and return the form to the Secretary; and
``(C) is then assessed using--
``(i) knowledge coupling computer software
that assesses overall health risks and then
provides options for management of identified
risk factors;
``(ii) nurse hotlines; and
``(iii) case managers as the Secretary
determines appropriate.
``(2) Individuals between the ages of 50 and 64.--With
respect to the target individuals described in subsection
(b)(2), the Secretary shall coordinate the delivery of the
self-assessment form with the issuance of the statement
described in section 1143(c)(2).
``(e) Periodic Followup.--
``(1) Medicare beneficiaries.--Not less frequently than
once every 2 years, the Secretary shall conduct periodic
followup appraisals with respect to the target individuals
described in subsection (b)(1) to reduce major behavioral risk
factors described in subsection (c)--
``(A) by providing such individuals with--
``(i) information regarding the results of
the self-administered risk appraisal;
``(ii) recommendations regarding behavior
modifications based on such appraisal; and
``(iii) information regarding any need for
further assessment or treatment; and
``(B) by providing the information described in
subparagraph (A) to the provider designated by such
individual to receive such information.
``(2) Individuals between the ages of 50 and 64.--The
Secretary shall conduct such periodic followup appraisals with
respect to the target individuals described in subsection
(b)(2) as the Secretary determines appropriate.''.
TITLE IV--DISEASE SELF-MANAGEMENT DEMONSTRATION PROJECTS
SEC. 401. DISEASE SELF-MANAGEMENT DEMONSTRATION PROJECTS.
(a) Demonstration Projects.--
(1) In general.--The Secretary, acting through the
Administrator of the Health Care Financing Administration,
shall conduct demonstration projects for the purpose of
promoting disease self-management for conditions identified by
the working group established under paragraph (2) for target
individuals (as defined in paragraph (3)).
(2) Disease self-management working group.--
(A) Establishment.--There is established within the
Department of Health and Human Services a Disease Self-
Management Working Group.
(B) Composition.--The Disease Self-Management
Working Group established under subparagraph (A) shall
be composed of 4 members as follows:
(i) The Administrator of the Health Care
Financing Administration.
(ii) The Director of the Centers for
Disease Control and Prevention.
(iii) The Administrator of the Agency for
Health Care Policy and Research.
(iv) The Director of the Administration on
Aging.
(C) General policies and criteria.--The Disease
Self-Management Working Group established under
paragraph (1) shall establish general policies and
criteria with respect to the functions of the Secretary
under this section including--
(i) the identification of conditions for
which a demonstration project may be
implemented;
(ii) the prioritization of the conditions
identified under clause (i) based on potential
of self-management of such condition to be
medically effective and for such self-
management to be a cost-effective benefit or
cost-saving benefit, as those terms are defined
in section 3 of this Act;
(iii) the identification of target
individuals;
(iv) the development of procedures for
selecting areas in which a demonstration
project may be implemented; and
(v) such other matters as are recommended
by the Disease Self-Management Working Group
and approved by the Secretary.
(3) Target individual defined.--In this section, the term
``target individual'' means an individual that is at risk for
or has a condition identified by the working group described
under paragraph (2) and is eligible for benefits under the fee-
for-service program under parts A and B of title XVIII of the
Social Security Act (42 U.S.C. 1395c et seq.; 1395j et seq.) or
is enrolled under the Medicare+Choice program under part C of
title XVIII of such Act (42 U.S.C. 1395w-21 et seq.).
(b) Number, Project Areas, and Duration.--
(1) Number.--Not later than 2 years after the date of
enactment of this Act, the Secretary shall implement a series
of demonstration projects.
(2) Project areas.--The Secretary, acting through the
Administrator of the Health Care Financing Administration,
shall implement the demonstration projects described in
paragraph (1) in urban, suburban, and rural areas.
(3) Duration.--The demonstration projects under this
section shall be conducted for a period of 3 years, beginning
on the date on which the Secretary implements the initial
demonstration project.
(c) Reports to Congress.--
(1) Annual reports.--
(A) In general.--Not later than 1 year after the
Secretary implements the initial demonstration project
under this section, and biannually thereafter, the
Secretary shall submit to Congress a report regarding
the demonstration projects conducted under this
section.
(B) Contents of report.--The report in subparagraph
(A) shall include the following:
(i) A description of the demonstration
projects conducted under this section.
(ii) An evaluation of--
(I) whether each benefit provided
under the demonstration project is a
cost-effective benefit or a cost-saving
benefit;
(II) the level of the disease self-
management attained by target
individuals under the demonstration
projects; and
(III) the satisfaction of target
individuals under the demonstration
project.
(iii) Any other information regarding the
demonstration projects conducted under this
section that the Secretary determines to be
appropriate.
(2) Final report.--Not later than 1 year after the
conclusion of the demonstration projects under this section,
the Secretary shall submit a final report to Congress on the
demonstration projects conducted under this section containing
the recommendations of the Secretary regarding whether to
conduct the demonstration projects on a permanent basis,
together with such recommendations for legislation and
administrative action as the Secretary considers appropriate.
(d) Funding.--The Secretary shall provide for the transfer from the
Federal Hospital Insurance Trust Fund under section 1817 of the Social
Security Act (42 U.S.C. 1395i) an amount not to exceed $30,000,000 for
the costs of carrying out the demonstration projects under this
section, establishing the Disease Self-Management Working Group under
subsection (a)(2), and submitting the reports to Congress under
subsection (c).
TITLE V--STUDIES AND REPORTS ADVANCING ORIGINAL RESEARCH IN THE FIELD
OF DISEASE PREVENTION AND THE ELDERLY
SEC. 501. MEDPAC BIANNUAL REPORT.
(a) In General.--Section 1805(b) of the Social Security Act (42
U.S.C. 1395b-6(b)) is amended--
(1) in paragraph (1)--
(A) in subparagraph (C), by striking ``and'' at the
end;
(B) in subparagraph (D), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(E) by not later than January 1, 2001, and
biannually thereafter, submit the report to Congress
described in paragraph (7).''; and
(2) by adding at the end the following:
``(7) Evaluation of actuarial equivalence of medicare and
private sector benefit packages.--
``(A) Evaluation.--The Commission shall--
``(i) evaluate the benefit package offered
under the medicare program under this title;
and
``(ii) determine the degree to which such
benefit package is actuarially equivalent to
that offered by health benefit programs
available in the private sector to individuals
over age 65.
``(B) Report.--The Commission shall submit a report
to Congress that shall contain--
``(i) a detailed statement of the findings
and conclusions of the Commission regarding the
evaluation conducted under subparagraph (A);
``(ii) the recommendations of the
Commission regarding changes in the benefit
package offered under the medicare program
under this title that would keep the program
modern and competitive in relation to health
benefit programs available in the private
sector; and
``(iii) the recommendations of the
Commission for such legislation and
administrative actions as it considers
appropriate.''.
(b) Effective Date.--The amendments made by this section shall take
effect on the date of enactment of this Act.
SEC. 502. NATIONAL INSTITUTE ON AGING STUDY AND REPORT.
(a) Studies.--The Director of the National Institute on Aging shall
conduct 1 or more studies focusing on ways to--
(1) improve quality of life for the elderly;
(2) develop better ways to prevent or delay the onset of
age-related functional decline and disease and disability among
the elderly; and
(3) develop means of assessing the long-term development of
cost-effective benefits and cost-savings benefits for health
promotion and disease prevention among the elderly.
(b) Report.--Not later than January 1, 2005, the Director of the
National Institute on Aging shall submit a report to the Secretary
regarding each study conducted under subsection (a) and containing a
detailed statement of research findings and conclusions that are
scientifically valid and are demonstrated to prevent or delay the onset
of chronic illness or disability among the elderly.
(c) Transmission to Institute of Medicine.--Upon receipt of each
report described in subsection (b), the Secretary shall transmit such
report to the Institute of Medicine of the National Academy of Sciences
for consideration in its effort to conduct the comprehensive study of
current literature and best practices in the field of health promotion
and disease prevention among the medicare beneficiaries described in
section 503.
(d) Authorization of Appropriations.--
(1) In general.--There are authorized to be appropriated
$100,000,000 for fiscal years 2000 through 2005 to carry out
the purposes of this section.
(2) Availability.--Any sums appropriated under the
authorization contained in this subsection shall remain
available, without fiscal year limitation, until September 30,
2004.
SEC. 503. INSTITUTE OF MEDICINE 5-YEAR MEDICARE PREVENTION BENEFIT
STUDY AND REPORT.
(a) Study.--
(1) In general.--The Secretary shall contract with the
Institute of Medicine of the National Academy of Sciences to
conduct a comprehensive study of current literature and best
practices in the field of health promotion and disease
prevention among medicare beneficiaries including the issues
described in paragraph (2) and to submit the report described
in subsection (b).
(2) Issues studied.--The study required under paragraph (1)
shall include an assessment of--
(A) whether each covered benefit is--
(i) medically effective; and
(ii) a cost-effective benefit or a cost-
saving benefit;
(B) utilization of covered benefits (including any
barriers to or incentives to increase utilization); and
(C) quality of life issues associated with both
health promotion and disease prevention benefits
covered under the medicare program and those that are
not covered under such program that would affect all
medicare beneficiaries.
(b) Report.--
(1) In general.--Not later than 5 years after the date of
enactment of this section, and every fifth year thereafter, the
Institute of Medicine of the National Academy of Sciences shall
submit to the President a report that contains a detailed
statement of the findings and conclusions of the study
conducted under subsection (a) and the recommendations for
legislation described in paragraph (2).
(2) Recommendations for legislation.--The Institute of
Medicine of the National Academy of Sciences, in consultation
with the Partnership for Prevention, shall develop
recommendations in legislative form that--
(A) prioritize the preventive benefits under the
medicare program; and
(B) modify preventive benefits offered under the
medicare program based on the study conducted under
subsection (a).
(c) Transmission to Congress.--
(1) In general.--On the day on which the report described
in subsection (b) is submitted to the President, the President
shall transmit the report and recommendations in legislative
form described in subsection (b)(2) to Congress.
(2) Delivery.--Copies of the report and recommendations in
legislative form required to be transmitted to Congress under
paragraph (1) shall be delivered--
(A) to both Houses of Congress on the same day;
(B) to the Clerk of the House of Representatives if
the House is not in session; and
(C) to the Secretary of the Senate if the Senate is
not in session.
SEC. 504. FAST-TRACK CONSIDERATION OF PREVENTION BENEFIT LEGISLATION.
(a) Rules of House of Representatives and Senate.--This section is
enacted by Congress--
(1) as an exercise of the rulemaking power of the House of
Representatives and the Senate, respectively, and is deemed a
part of the rules of each House of Congress, but--
(A) is applicable only with respect to the
procedure to be followed in that House of Congress in
the case of an implementing bill (as defined in
subsection (d)); and
(B) supersedes other rules only to the extent that
such rules are inconsistent with this section; and
(2) with full recognition of the constitutional right of
either House of Congress to change the rules (so far as
relating to the procedure of that House of Congress) at any
time, in the same manner and to the same extent as in the case
of any other rule of that House of Congress.
(b) Introduction and Referral.--
(1) Introduction.--
(A) In general.--Subject to paragraph (2), on the
day on which the President transmits the report
pursuant to section 503(c) to the House of
Representatives and the Senate, the recommendations in
legislative form transmitted by the President with
respect to such report shall be introduced as a bill
(by request) in the following manner:
(i) House of representatives.--In the House
of Representatives, by the Majority Leader, for
himself and the Minority Leader, or by Members
of the House of Representatives designated by
the Majority Leader and Minority Leader.
(ii) Senate.--In the Senate, by the
Majority Leader, for himself and the Minority
Leader, or by Members of the Senate designated
by the Majority Leader and Minority Leader.
(B) Special rule.--If either House of Congress is
not in session on the day on which such recommendations
in legislative form are transmitted, the
recommendations in legislative form shall be introduced
as a bill in that House of Congress, as provided in
subparagraph (A), on the first day thereafter on which
that House of Congress is in session.
(2) Referral.--Such bills shall be referred by the
presiding officers of the respective Houses to the appropriate
committee, or, in the case of a bill containing provisions
within the jurisdiction of 2 or more committees, jointly to
such committees for consideration of those provisions within
their respective jurisdictions.
(c) Consideration.--After the recommendations in legislative form
have been introduced as a bill and referred under subsection (b), such
implementing bill shall be considered in the same manner as an
implementing bill is considered under subsections (d), (e), (f), and
(g) of section 151 of the Trade Act of 1974 (19 U.S.C. 2191).
(d) Implementing Bill Defined.--In this section, the term
``implementing bill'' means only the recommendations in legislative
form of the Institute of Medicine of the National Academy of Sciences
described in section 503(b)(2), transmitted by the President to the
House of Representatives and the Senate under subsection 503(c), and
introduced and referred as provided in subsection (b) as a bill of
either House of Congress.
(e) Counting of Days.--For purposes of this section, any period of
days referred to in section 151 of the Trade Act of 1974 shall be
computed by excluding--
(1) the days on which either House of Congress is not in
session because of an adjournment of more than 3 days to a day
certain or an adjournment of Congress sine die; and
(2) any Saturday and Sunday, not excluded under paragraph
(1), when either House is not in session.
<all>
Introduced in Senate
Sponsor introductory remarks on measure. (CR S11259-11260)
Read twice and referred to the Committee on Finance.
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