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BALANCED BUDGET ACT OF 1997
(House of Representatives - June 25, 1997)
Text of this article available as:
[Pages H4416-H4606]
[[Page H4416]]
BALANCED BUDGET ACT OF 1997
Mr. KASICH. Mr. Speaker, pursuant to House Resolution 174, I call up
the bill (H.R. 2015) to provide for reconciliation pursuant to
subsections (b)(1) and (c) of section 105 of the concurrent resolution
on the budget for fiscal year 1998, and ask for its immediate
consideration.
The Clerk read the title of the bill.
The SPEAKER pro tempore (Mr. Dreier). Pursuant to House Resolution
174, the amendment printed in the Congressional Record numbered 1 is
adopted.
The text of H.R. 2015, as amended, is as follows:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Balanced Budget Act of
1997''.
SEC. 2. TABLE OF CONTENTS.
Title I--Committee on Agriculture.
Title II--Committee on Banking and Financial Services.
Title III--Committee on Commerce--Nonmedicare.
Title IV--Committee on Commerce--Medicare.
Title V--Committee on Education and the Workforce.
Tittle VI--Committee on Government Reform and Oversight.
Title VII--Committee on Transportation and Infrastructure.
Title VIII--Committee on Veterans' Affairs.
Title IX--Committee on Ways and Means--Nonmedicare.
Title X--Committee on Ways and Means--Medicare.
Title XI--Budget Enforcement.
TITLE I--COMMITTEE ON AGRICULTURE
SEC. 1001. EXEMPTION.
Section 6(o) of the Food Stamp Act of 1977 (7 U.S.C.
2015(o)) is amended--
(1) in paragraph (2)(D), by striking ``or (5)'' and
inserting ``(5), or (6)'';
(2) by redesignating paragraphs (5) and (6) as paragraphs
(6) and (7), respectively; and
(3) by inserting after paragraph (4) the following new
paragraph:
``(5) 15-percent exemption.--
``(A) Definitions.--In this paragraph:
``(i) Caseload.--The term `caseload' means the average
monthly number of individuals receiving food stamps during
the 12-month period ending the preceding June 30.
``(ii) Covered individual.--The term `covered individual'
means a food stamp recipient, or an individual denied
eligibility for food stamp benefits solely due to paragraph
(2), who--
``(I) is not eligible for an exception under paragraph (3);
``(II) does not reside in an area covered by a waiver
granted under paragraph (4);
``(III) is not complying with subparagraph (A), (B), or (C)
of paragraph (2);
``(IV) is not in the first 3 months of eligibility under
paragraph (2); and
``(V) is not receiving benefits under paragraph (6).
``(B) General rule.--Subject to subparagraphs (C) through
(F), a State agency may provide an exemption from the
requirements of paragraph (2) for covered individuals.
``(C) Fiscal year 1998.--Subject to subparagraph (E), for
fiscal year 1998, a State agency may provide a number of
exemptions such that the average monthly number of the
exemptions in effect during the fiscal year does not exceed
15 percent of the number of covered individuals in the State
in fiscal year 1998, as estimated by the Secretary, based on
the survey conducted to carry out section 16(c) for fiscal
year 1996 and such other factors as the Secretary considers
appropriate due to the timing and limitations of the survey.
``(D) Subsequent fiscal years.--Subject to subparagraphs
(E) and (F), for fiscal year 1999 and each subsequent fiscal
year, a State agency may provide a number of exemptions such
that the average monthly number of the exemptions in effect
during the fiscal year does not exceed 15 percent of the
number of covered individuals in the State, as estimated by
the Secretary under subparagraph (C), adjusted by the
Secretary to reflect changes in the State's caseload and the
Secretary's estimate of changes in the proportion of food
stamp recipients covered by waivers granted under paragraph
(4).
``(E) Caseload adjustments.--The Secretary shall adjust the
number of individuals estimated for a State under
subparagraph (C) or (D) during a fiscal year if the number of
food stamp recipients in the State varies by a significant
number from the caseload, as determined by the Secretary.
``(F) Exemption adjustments.--During fiscal year 1999 and
each subsequent fiscal year, the Secretary shall increase or
decrease the number of individuals who may be granted an
exemption by a State agency to the extent that the average
monthly number of exemptions in effect in the State for the
preceding fiscal year is greater or less than the average
monthly number of exemptions estimated for the State agency
during such preceding fiscal year.
``(G) Reporting requirement.--A State agency shall submit
such reports to the Secretary as the Secretary determines are
necessary to ensure compliance with this paragraph.''.
SEC. 1002. ADDITIONAL FUNDING FOR EMPLOYMENT AND TRAINING.
(a) In General.--Section 16(h) of the Food Stamp Act of
1977 (7 U.S.C. 2025(h)) is amended--
(1) by striking paragraph (1) and inserting the following
new paragraph:
``(1) In general.--
``(A) Amounts.--To carry out employment and training
programs, the Secretary shall reserve for allocation to State
agencies, to remain available until expended, from funds made
available for each fiscal year under section 18(a)(1) the
amount of--
``(i) for fiscal year 1996, $75,000,000;
``(ii) for fiscal year 1997, $79,000,000;
``(iii) for fiscal year 1998, $221,000,000;
``(iv) for fiscal year 1999, $224,000,000;
``(v) for fiscal year 2000, $226,000,000;
``(vi) for fiscal year 2001, $228,000,000; and
``(vii) for fiscal year 2002, $210,000,000.
``(B) Limitations.--The Secretary shall ensure that--
``(i) the funds provided in this subparagraph shall not be
used for food stamp recipients who receive benefits under a
State program funded under part A of title IV of the Social
Security Act (42 U.S.C. 601 et seq.); and
``(ii) not less than 80 percent of the funds provided in
this subparagraph shall be used by a State agency for
employment and training programs under section 6(d)(4), other
than job search or job search training programs, for food
stamp recipients not excepted by section 6(o)(3).
``(C) Allocation.--
``(i) Allocation formula.--The Secretary shall allocate the
amounts reserved under subparagraph (A) among the State
agencies using a reasonable formula, as determined and
adjusted by the Secretary each fiscal year, to reflect
changes in each State's caseload (as defined in section
6(o)(5)(A)) that reflects the proportion of food stamp
recipients who reside in each State--
``(I) who are not eligible for an exception under section
6(o)(3); and
``(II) who do not reside in an area subject to the waiver
granted by the Secretary under section 6(o)(4), if the State
agency does not provide employment and training services in
the area to food stamp recipients not excepted by section
6(o)(3).
``(ii) Reporting requirement.--A State agency shall submit
such reports to the Secretary as the Secretary determines are
necessary to ensure compliance with this paragraph.''; and
``(D) Reallocation.--
``(i) Notification.--A State agency shall promptly notify
the Secretary if the State agency determines that it will not
expend all of the funds allocated to it under subparagraph
(B).
``(ii) Reallocation.--On notification under clause (i), the
Secretary shall reallocate the funds that the State agency
will not expend as the Secretary considers appropriate and
equitable.
``(E) Minimum allocation.--Notwithstanding subparagraphs
(A) through (C), the Secretary shall ensure that each State
agency operating an employment and training program shall
receive not less than $50,000 for each fiscal year.
``(F) Maintenance of effort.--To receive the additional
funding under subparagraph (A), as provided by the amendment
made by section 1002 of the Balanced Budget Act of 1997, a
State agency shall maintain the expenditures of the State
agency for employment and training programs and workfare
programs for any fiscal year under paragraph (2), and
administrative expenses under section 20(g)(1), at a level
that is not less than the level of the expenditures by the
State agency to carry out the programs for fiscal year
1996.'';
(2) by redesignating paragraphs (2) through (5) as
paragraphs (3) through (6), respectively;
(3) by inserting after paragraph (1) the following new
paragraph:
``(2) Report to congress on additional funding.--Beginning
one year after the date of the enactment of this paragraph,
the Secretary shall submit an annual report to the Committee
on Agriculture of the House of Representatives and the
Committee on Agriculture, Nutrition, and Forestry of the
Senate regarding whether the additional funding provided
under paragraph (1)(A) has been utilized by State agencies to
increase the number of work slots in their employment and
training programs and workfare for recipients subject to
section 6(o) in the most efficient and effective manner.'';
and
(4) in paragraph (3) (as so redesignated), by striking
``paragraph (3)'' and inserting ``paragraph (4)''.
(b) Conforming Amendments.--(1) Subsection
(b)(1)(B)(iv)(III)(hh) of section 17 of the Food Stamp Act of
1977 (7 U.S.C. 2026) is amended by striking ``(h)(2), or
(h)(3) of section 16'' and inserting ``(h)(3), or (h)(4) of
section 16''.
(2) Subsection (d)(1)(B)(ii) of section 22 of such Act (7
U.S.C. 2031) is amended by striking ``(h)(2), and (h)(3) of
section 16'' and inserting ``(h)(3), and (h)(4) of section
16''.
SEC. 1003. AUTHORIZING USE OF NONGOVERNMENTAL PERSONNEL IN
MAKING DETERMINATIONS OF ELIGIBILITY FOR
BENEFITS UNDER THE FOOD STAMP PROGRAM.
(a) In General.--Notwithstanding any other provision of
law, no provision of law shall be construed as preventing any
State (as defined in section 3(m) of the Food Stamp Act of
1977 (7 U.S.C. 2012(m))) from allowing eligibility
determinations described in subsection (b) to be made by an
entity that is not a State or local government, or by an
individual who is not an employee of a State or
[[Page H4417]]
local government, which meets such qualifications as the
State determines. For purposes of any Federal law, such
determinations shall be considered to be made by the State
and by a State agency.
(b) Eligibility Determinations.--An eligibility
determination described in this subsection is a determination
of eligibility of individuals or households to receive
benefits under the food stamp program as defined in section
3(h) of the Food Stamp Act of 1977 (7 U.S.C. 2012(h)).
(c) Construction.--Nothing in this section shall be
construed as affecting--
(1) the conditions for eligibility for benefits (including
any conditions relating to income or resources);
(2) the rights to challenge determinations regarding
eligibility or rights to benefits; and
(3) determinations regarding quality control or error
rates.
TITLE II--COMMITTEE ON BANKING AND FINANCIAL SERVICES
SEC. 2001. TABLE OF CONTENTS.
The table of contents for this title is as follows:
TITLE II--COMMITTEE ON BANKING AND FINANCIAL SERVICES
Sec. 2001. Table of contents.
Sec. 2002. Extension of foreclosure avoidance and borrower assistance
provisions for FHA single family housing mortgage
insurance program.
Sec. 2003. Adjustment of maximum monthly rents for certain dwelling
units in new construction and substantial or moderate
rehabilitation projects assisted under section 8 rental
assistance program.
Sec. 2004. Adjustment of maximum monthly rents for non-turnover
dwelling units assisted under section 8 rental assistance
program.
SEC. 2002. EXTENSION OF FORECLOSURE AVOIDANCE AND BORROWER
ASSISTANCE PROVISIONS FOR FHA SINGLE FAMILY
HOUSING MORTGAGE INSURANCE PROGRAM.
Section 407 of The Balanced Budget Downpayment Act, I (12
U.S.C. 1710 note) is amended--
(1) in subsection (c)--
(A) by striking ``only''; and
(B) by inserting ``, on, or after'' after ``before''; and
(2) by striking subsection (e).
SEC. 2003. ADJUSTMENT OF MAXIMUM MONTHLY RENTS FOR CERTAIN
DWELLING UNITS IN NEW CONSTRUCTION AND
SUBSTANTIAL OR MODERATE REHABILITATION PROJECTS
ASSISTED UNDER SECTION 8 RENTAL ASSISTANCE
PROGRAM.
The third sentence of section 8(c)(2)(A) of the United
States Housing Act of 1937 (42 U.S.C. 1437f(c)(2)(A)) is
amended by inserting before the period at the end the
following: ``, and during fiscal year 1999 and thereafter''.
SEC. 2004. ADJUSTMENT OF MAXIMUM MONTHLY RENTS FOR NON-
TURNOVER DWELLING UNITS ASSISTED UNDER SECTION
8 RENTAL ASSISTANCE PROGRAM.
The last sentence of section 8(c)(2)(A) of the United
States Housing Act of 1937 is amended by inserting before the
period at the end the following: ``, and during fiscal year
1999 and thereafter''.
TITLE III--COMMITTEE ON COMMERCE-NONMEDICARE
Subtitle A--Nuclear Regulatory Commission Annual Charges
SEC. 3001. NUCLEAR REGULATORY COMMISSION ANNUAL CHARGES.
Section 6101(a)(3) of the Omnibus Budget Reconciliation Act
of 1990 (42 U.S.C. 2214(a)(3)) is amended by striking
``September 30, 1998'' and inserting ``September 30, 2002''.
Subtitle B--Lease of Excess Strategic Petroleum Reserve Capacity
SEC. 3101. LEASE OF EXCESS STRATEGIC PETROLEUM RESERVE
CAPACITY.
(a) Amendment.--Part B of title I of the Energy Policy and
Conservation Act (42 U.S.C. 6231 et seq.) is amended by
adding at the end the following:
``USE OF UNDERUTILIZED FACILITIES
``Sec. 168. (a) Authority.--Notwithstanding any other
provision of this title, the Secretary, by lease or
otherwise, for any term and under such other conditions as
the Secretary considers necessary or appropriate, may store
in underutilized Strategic Petroleum Reserve facilities
petroleum product owned by a foreign government or its
representative. Petroleum products stored under this section
are not part of the Strategic Petroleum Reserve and may be
exported without license from the United States.
``(b) Protection of Facilities.--All agreements entered
into pursuant to subsection (a) shall contain provisions
providing for fees to fully compensate the United States for
all costs of storage and removals of petroleum products,
including the cost of replacement facilities necessitated as
a result of any withdrawals.
``(c) Access to Stored Oil.--The Secretary shall ensure
that agreements to store petroleum products for foreign
governments or their representatives do not affect the
ability of the United States to withdraw, distribute, or sell
petroleum from the Strategic Petroleum Reserve in response to
an energy emergency or to the obligations of the United
States under the Agreement on an International Energy
Program.
``(d) Availability of Funds.--Funds collected through the
leasing of Strategic Petroleum Reserve facilities authorized
by subsection (a) after September 30, 2002, shall be used by
the Secretary of Energy without further appropriation for the
purchase of oil for, and operation and maintenance costs of,
the Strategic Petroleum Reserve.''.
(b) Table of Contents Amendment.--The table of contents of
part B of title I of the Energy Policy and Conservation Act
is amended by adding at the end the following:
``Sec. 168. Use of underutilized facilities.''.
Subtitle C--Sale of DOE Assets
SEC. 3201. SALE OF DOE SURPLUS URANIUM ASSETS.
(a) In General.--The Secretary of Energy shall, during the
period fiscal year 1999 through fiscal year 2002, sell 3.2
million pounds per year of natural and low-enriched uranium
that the President has determined is not necessary for
national security needs. Such sales shall be--
(1) made for delivery after January 1, 1999;
(2) subject to a determination, for the period fiscal year
1999 through fiscal year 2002, by the Secretary under section
3112(d)(2)(B) of the USEC Privatization Act (42 U.S.C. 2297h-
10(d)(2)(B)); and
(3) made at a price not less than the fair market value of
the uranium and in a manner that maximizes proceeds to the
Treasury.
The Secretary shall receive the proceeds from such sale in
the period fiscal year 1999 through fiscal year 2002 and
shall deposit such proceeds in the General Fund of the
Treasury.
(b) Costs.--The costs of making the sales required by
subsection (a) shall be covered by the unobligated balances
of appropriations of the Department of Energy.
Subtitle D--Communications
SEC. 3301. SPECTRUM AUCTIONS.
(a) Extension and Expansion of Auction Authority.--
(1) Amendments.--Section 309(j) of the Communications Act
of 1934 (47 U.S.C. 309(j)) is amended--
(A) by striking paragraphs (1) and (2) and inserting in
lieu thereof the following:
``(1) General authority.--If, consistent with the
obligations described in paragraph (6)(E), mutually exclusive
applications are accepted for any initial license or
construction permit which will involve an exclusive use of
the electromagnetic spectrum, then the Commission shall grant
such license or permit to a qualified applicant through a
system of competitive bidding that meets the requirements of
this subsection.
``(2) Exemptions.--The competitive bidding authority
granted by this subsection shall not apply to licenses or
construction permits issued by the Commission--
``(A) that, as the result of the Commission carrying out
the obligations described in paragraph (6)(E), are not
mutually exclusive;
``(B) for public safety radio services, including private
internal radio services used by non-Government entities,
that--
``(i) protect the safety of life, health, or property; and
``(ii) are not made commercially available to the public;
``(C) for initial licenses or construction permits assigned
by the Commission to existing terrestrial broadcast licensees
for new terrestrial digital television services; or
``(D) for public telecommunications services, as defined in
section 397(14) of the Communications Act of 1934 (47 U.S.C.
397(14)), when the license application is for channels
reserved for noncommercial use.'';
(B) in paragraph (3)--
(i) by inserting after the second sentence the following
new sentence: ``The Commission shall, directly or by
contract, provide for the design and conduct (for purposes of
testing) of competitive bidding using a contingent
combinatorial bidding system that permits prospective bidders
to bid on combinations or groups of licenses in a single bid
and to enter multiple alternative bids within a single
bidding round.'';
(ii) by striking ``and'' at the end of subparagraph (C);
(iii) by striking the period at the end of subparagraph (D)
and inserting ``; and''; and
(iv) by adding at the end the following new subparagraph:
``(E) ensuring that, in the scheduling of any competitive
bidding under this subsection, an adequate period is
allowed--
``(i) before issuance of bidding rules, to permit notice
and comment on proposed auction procedures; and
``(ii) after issuance of bidding rules, to ensure that
interested parties have a sufficient time to develop business
plans, assess market conditions, and evaluate the
availability of equipment for the relevant services.'';
(C) in paragraph (4)--
(i) by striking ``and'' at the end of subparagraph (D);
(ii) by striking the period at the end of subparagraph (E)
and inserting ``; and''; and
(iii) by adding at the end the following new subparagraph:
``(F) establish methods by which a minimum bid, in an
amount that is more than nominal in relation to the value of
the public spectrum resource being made available, will be
required to obtain any license or permit being assigned
pursuant to the competitive bidding.'';
(D) in paragraph (8)--
(i) by striking subparagraph (B); and
(ii) by redesignating subparagraph (C) as subparagraph (B);
(E) in paragraph (11), by striking ``September 30, 1998''
and inserting ``December 31, 2002''; and
[[Page H4418]]
(F) in paragraph (13)(F), by striking ``September 30,
1998'' and inserting ``the date of enactment of the Balanced
Budget Act of 1997''.
(2) Conforming amendment.--Subsection (i) of section 309 of
the Communications Act of 1934 (47 U.S.C. 309(i)) is
repealed.
(3) Effective date.--The amendment made by paragraph (1)(A)
shall not apply with respect to any license or permit for
which the Federal Communications Commission has accepted
mutually exclusive applications on or before the date of
enactment of this Act.
(b) Commission Obligation To Make Additional Spectrum
Available by Auction.--
(1) In general.--The Federal Communications Commission
shall complete all actions necessary to permit the
assignment, by September 30, 2002, by competitive bidding
pursuant to section 309(j) of the Communications Act of 1934
(47 U.S.C. 309(j)) of licenses for the use of bands of
frequencies that--
(A) individually span not less than 25 megahertz, unless a
combination of smaller bands can, notwithstanding the
provisions of paragraph (7) of such section, reasonably be
expected to produce greater receipts;
(B) in the aggregate span not less than 100 megahertz;
(C) are located below 3 gigahertz;
(D) have not, as of the date of enactment of this Act--
(i) been designated by Commission regulation for assignment
pursuant to such section;
(ii) been identified by the Secretary of Commerce pursuant
to section 113 of the National Telecommunications and
Information Administration Organization Act;
(iii) been allocated for Federal Government use pursuant to
section 305 of the Communications Act of 1934 (47 U.S.C.
305);
(iv) been designated in section 3303 of this Act; or
(v) been allocated for unlicensed use pursuant to part 15
of the Commission's regulations (47 C.F.R. Part 15), if the
competitive bidding for licenses would interfere with
operation of end-user products permitted under such
regulations;
(E) notwithstanding section 115(b)(1)(B) of the National
Telecommunications and Information Administration
Organization Act (47 U.S.C. 925(b)(1)(B)) or any proposal
pursuant to such section, include frequencies at 1,710-1,755
megahertz;
(F) include frequencies at 2,110-2,150 megahertz; and
(G) include 15 megahertz from within the bands of
frequencies at 1,990-2,110 megahertz.
(2) Schedule for assignment of 1,710-1,755 megahertz.--The
Commission shall commence competitive bidding for the
commercial licenses pursuant to paragraph (1)(E) after
January 1, 2001. The Commission shall complete the assignment
of such commercial licenses, and report to the Congress the
total revenues from such competitive bidding, by September
30, 2002.
(3) Use of bands at 2,110-2,150 megahertz.--The Commission
shall reallocate spectrum located at 2,110-2,150 megahertz
for assignment by competitive bidding unless the Commission
determines that auction of other spectrum (A) better serves
the public interest, convenience, and necessity, and (B) can
reasonably be expected to produce greater receipts. If the
Commission makes such a determination, then the Commission
shall, within 2 years after the date of enactment of this
Act, identify an alternative 40 megahertz, and report to the
Congress an identification of such alternative 40 megahertz
for assignment by competitive bidding.
(4) Use of 15 megahertz from bands at 1,990-2,110
megahertz.--The Commission shall reallocate 15 megahertz from
spectrum located at 1,990-2,110 megahertz for assignment by
competitive bidding unless the President determines such
spectrum cannot be reallocated due to the need to protect
incumbent Federal systems from interference, and that
allocation of other spectrum (A) better serves the public
interest, convenience, and necessity, and (B) can reasonably
be expected to produce greater receipts. If the President
makes such a determination, then the President shall, within
2 years after the date of enactment of this Act, identify
alternative bands of frequencies totalling 15 megahertz, and
report to the Congress an identification of such alternative
bands for assignment by competitive bidding.
(5) Criteria for reassignment.--In making available bands
of frequencies for competitive bidding pursuant to paragraph
(1), the Commission shall--
(A) seek to promote the most efficient use of the spectrum;
(B) take into account the cost to incumbent licensees of
relocating existing uses to other bands of frequencies or
other means of communication; and
(C) comply with the requirements of international
agreements concerning spectrum allocations.
(6) Notification to ntia.--The Commission shall notify the
Secretary of Commerce if--
(A) the Commission is not able to provide for the effective
relocation of incumbent licensees to bands of frequencies
that are available to the Commission for assignment; and
(B) the Commission has identified bands of frequencies that
are--
(i) suitable for the relocation of such licensees; and
(ii) allocated for Federal Government use, but that could
be reallocated pursuant to part B of the National
Telecommunications and Information Administration
Organization Act (as amended by this Act).
(c) Identification and Reallocation of Frequencies.--The
National Telecommunications and Information Administration
Organization Act (47 U.S.C. 901 et seq.) is amended--
(1) in section 113, by adding at the end the following new
subsection:
``(f) Additional Reallocation Report.--If the Secretary
receives a notice from the Commission pursuant to section
3301(b)(3) of the Balanced Budget Act of 1997, the Secretary
shall prepare and submit to the President, the Commission,
and the Congress a report recommending for reallocation for
use other than by Federal Government stations under section
305 of the 1934 Act (47 U.S.C. 305), bands of frequencies
that are suitable for the uses identified in the Commission's
notice. The Commission shall, not later than one year after
receipt of such report, prepare, submit to the President and
the Congress, and implement, a plan for the immediate
allocation and assignment of such frequencies under the 1934
Act to incumbent licencees described in section 3301(b)(3) of
the Balanced Budget Act of 1997.''; and
(2) in section 114(a)(1), by striking ``(a) or (d)(1)'' and
inserting ``(a), (d)(1), or (f)''.
(d) Identification and Reallocation of Auctionable
Frequencies.--The National Telecommunications and Information
Administration Organization Act (47 U.S.C. 901 et seq.) is
amended--
(1) in section 113(b)--
(A) by striking the heading of paragraph (1) and inserting
``Initial reallocation report'';
(B) by inserting ``in the first report required by
subsection (a)'' after ``recommend for reallocation'' in
paragraph (1);
(C) by inserting ``or (3)'' after ``paragraph (1)'' each
place it appears in paragraph (2); and
(D) by inserting after paragraph (2) the following new
paragraph:
``(3) Second reallocation report.--In accordance with the
provisions of this section, the Secretary shall recommend for
reallocation in the second report required by subsection (a),
for use other than by Federal Government stations under
section 305 of the 1934 Act (47 U.S.C. 305), a band or bands
of frequencies that--
``(A) in the aggregate span not less than 20 megahertz;
``(B) individually span not less than 20 megahertz, unless
a combination of smaller bands can reasonably be expected to
produce greater receipts;
``(C) are located below 3 gigahertz; and
``(D) meet the criteria specified in paragraphs (1) through
(5) of subsection (a).''; and
(2) in section 115--
(A) in subsection (b), by striking ``the report required by
section 113(a)'' and inserting ``the initial reallocation
report required by section 113(a)''; and
(B) by adding at the end the following new subsection:
``(c) Allocation and Assignment of Frequencies Identified
in the Second Reallocation Report.--With respect to the
frequencies made available for reallocation pursuant to
section 113(b)(3), the Commission shall, not later than one
year after receipt of the second reallocation report required
by such section, prepare, submit to the President and the
Congress, and implement, a plan for the immediate allocation
and assignment under the 1934 Act of all such frequencies in
accordance with section 309(j) of such Act.''.
SEC. 3302. AUCTION OF RECAPTURED BROADCAST TELEVISION
SPECTRUM.
Section 309(j) of the Communications Act of 1934 (47 U.S.C.
309(j)) is amended by adding at the end the following new
paragraph:
``(14) Auction of recaptured broadcast television
spectrum.--
``(A) Limitations on terms of terrestrial television
broadcast licenses.--A television license that authorizes
analog television services may not be renewed to authorize
such service for a period that extends beyond December 31,
2006. The Commission shall have the authority to grant by
regulation an extension of such date to licensees in a market
if the Commission determines that more than 5 percent of
households in such market continue to rely exclusively on
over-the-air terrestrial analog television signals.
``(B) Spectrum reversion and resale.--
``(i) The Commission shall ensure that, when the authority
to broadcast analog television services under a license
expires pursuant to subparagraph (A), each licensee shall
return spectrum according to the Commission's direction and
the Commission shall reclaim such spectrum.
``(ii) Licensees for new services occupying spectrum
reclaimed pursuant to clause (i) shall be selected in
accordance with this subsection. The Commission shall
complete the assignment of such licenses, and report to the
Congress the total revenues from such competitive bidding, by
September 30, 2002.
``(C) Certain limitations on qualified bidders
prohibited.--In prescribing any regulations relating to the
qualification of bidders for spectrum reclaimed pursuant to
subparagraph (B)(i), the Commission shall not--
``(i) preclude any party from being a qualified bidder for
spectrum that is allocated for any use that includes digital
television service on the basis of--
``(I) the Commission's duopoly rule (47 C.F.R. 73.3555(b));
or
``(II) the Commission's newspaper cross-ownership rule (47
C.F.R. 73.3555(d)); or
``(ii) apply either such rule to preclude such a party that
is a successful bidder in a
[[Page H4419]]
competitive bidding for such spectrum from using such
spectrum for digital television service.
``(D) Definitions.--As used in this paragraph:
``(i) The term `digital television service' means
television service provided using digital technology to
enhance audio quality and video resolution, as further
defined in the Memorandum Opinion, Report, and Order of the
Commission entitled `Advanced Television Systems and Their
Impact Upon the Existing Television Service', MM Docket No.
87-268 and any subsequent Commission proceedings dealing with
digital television.
``(ii) The term `analog television service' means service
provided pursuant to the transmission standards prescribed by
the Commission in section 73.682(a) of its regulation (47 CFR
73.682(a)).''.
SEC. 3303. ALLOCATION AND ASSIGNMENT OF NEW PUBLIC SAFETY AND
COMMERCIAL LICENSES.
(a) In General.--The Federal Communications Commission
shall, not later than January 1, 1998, allocate on a
national, regional, or market basis, from radio spectrum
between 746 megahertz and 806 megahertz--
(1) 24 megahertz of that spectrum for public safety
services according to the terms and conditions established by
the Commission, unless the Commission determines that the
needs for public safety services can be met in particular
areas with allocations of less than 24 megahertz; and
(2) the remainder of that spectrum for commercial purposes
to be assigned by competitive bidding in accordance with
section 309(j).
(b) Assignment.--The Commission shall--
(1) assign the licenses for public safety created pursuant
to subsection (a) no later than March 31, 1998;
(2) commence competitive bidding for the commercial
licenses created pursuant to subsection (a) after January 1,
2001; and
(3) complete competitive bidding for such commercial
licenses, and report to the Congress the total revenues from
such competitive bidding, by September 30, 2002.
(c) Licensing of Unused Frequencies for Public Safety Radio
Services.--
(1) Use of unused channels for public safety.--It shall be
the policy of the Commission, notwithstanding any other
provision of this Act or any other law, to waive whatever
licensee eligibility and other requirements (including
bidding requirements) are applicable in order to permit the
use of unassigned frequencies for public safety purposes by a
State or local governmental agency upon a showing that--
(A) no other existing satisfactory public safety channel is
immediately available to satisfy the requested use;
(B) the proposed use is technically feasible without
causing harmful interference to existing stations in the
frequency band entitled to protection from such interference
under the rules of the Commission; and
(C) use of the channel for public safety purposes is
consistent with other existing public safety channel
allocations in the geographic area of proposed use.
(2) Applicability.--Paragraph (1) shall apply to any
application that is pending before the Federal Communications
Commission, or that is not finally determined under either
section 402 or 405 of the Communications Act of 1934 (47
U.S.C. 402, 405) on May 15, 1997, or that is filed after such
date.
(d) Conditions on Licenses.--With respect to public safety
and commercial licenses granted pursuant to this subsection,
the Commission shall--
(1) establish interference limits at the boundaries of the
spectrum block and service area;
(2) establish any additional technical restrictions
necessary to protect full-service analog television service
and digital television service during a transition to digital
television service; and
(3) permit public safety and commercial licensees--
(A) to aggregate multiple licenses to create larger
spectrum blocks and service areas; and
(B) to disaggregate or partition licenses to create smaller
spectrum blocks or service areas.
(e) Protection of Qualifying Low-Power Stations.--After
making any allocation or assignment under this section the
Commission shall seek to assure that each qualifying low-
power television station is assigned a frequency below 746
megahertz to permit the continued operation of such station.
(f) Definitions.--For purposes of this section:
(1) Commission.--The term ``Commission'' means the Federal
Communications Commission.
(2) Digital television service.--The term ``digital
television service'' means television service provided using
digital technology to enhance audio quality and video
resolution, as further defined in the Memorandum Opinion,
Report, and Order of the Commission entitled `Advanced
Television Systems and Their Impact Upon the Existing
Television Service', MM Docket No. 87-268 and any subsequent
Commission proceedings dealing with digital television.
(3) Analog television service.--The term ``analog
television service'' means services provided pursuant to the
transmission standards prescribed by the Commission in
section 73.682(a) of its regulation (47 CFR 73.682(a)).
(4) Public safety services.--The term ``public safety
services'' means services--
(A) the sole or principal purpose of which is to protect
the safety of life, health, or property;
(B) that are provided--
(i) by State or local government entities; or
(ii) by nongovernmental, private organizations that are
authorized by a governmental entity whose primary mission is
the provision of such services; and
(C) that are not made commercially available to the public
by the provider.
(5) Service area.--The term ``service area'' means the
geographic area over which a licensee may provide service and
is protected from interference.
(6) Spectrum block.--The term ``spectrum block'' means the
range of frequencies over which the apparatus licensed by the
Commission is authorized to transmit signals.
(7) Qualifying low-power television stations.--A station is
a qualifying low-power television station if, during the 90
days preceding the date of enactment of this Act--
(A) such station broadcast a minimum of 18 hours per day;
(B) such station broadcast an average of at least 3 hours
per week of programming that was produced within the
community of license of such station; and
(C) such station was in compliance with the requirements
applicable to low-power television stations.
SEC. 3304. ADMINISTRATIVE PROCEDURES FOR SPECTRUM AUCTIONS.
(a) Expedited Procedures.--The rules governing competitive
bidding under this subtitle shall be effective immediately
upon publication in the Federal Register notwithstanding
section 553(d), 801(a)(3), and 806(a) of title 5, United
States Code. Chapter 6 of such title, and sections 3507 and
3512 of title 44, United States Code, shall not apply to such
rules and competitive bidding procedures governing
frequencies assigned under this subtitle. Notwithstanding
section 309(b) of the Communications Act of 1934 (47 U.S.C.
309(b)), no application for an instrument of authorization
for such frequencies shall be granted by the Commission
earlier than 7 days following issuance of public notice by
the Commission of the acceptance for filing of such
application or of any substantial amendment thereto.
Notwithstanding section 309(d)(1) of such Act (47 U.S.C.
309(d)(1)), the Commission may specify a period (no less than
5 days following issuance of such public notice) for the
filing of petitions to deny any application for an instrument
of authorization for such frequencies.
(b) Deadline for Collection.--The Commission shall conduct
the competitive bidding under this subtitle in a manner that
ensures that all proceeds of the bidding are deposited in
accordance with section 309(j)(8) of the Communications Act
of 1934 not later September 30, 2002.
SEC. 3305. UNIVERSAL SERVICE FUND PAYMENT SCHEDULE.
(a) Acceleration of Payments.--There shall be available in
fiscal year 2001 from funds in the Treasury not otherwise
appropriated $2,000,000,000 to the universal service fund
under part 54 of the Federal Communications Commission's
regulations (47 C.F.R. Part 54) in addition to any other
revenues required to be collected under such part.
(b) Limitation on Expenditures.--The outlays of the
universal service fund under part 54 of the Federal
Communications Commission's regulations (47 C.F.R. Part 54)
in fiscal year 2002 shall not exceed the amount of revenue
required to be collected in such fiscal year, less
$2,000,000,000.
SEC. 3306. INQUIRY REQUIRED.
The Federal Communications Commission shall, not later than
July 1, 1997, initiate the inquiry required by section
309(j)(12) of the Communications Act of 1934 (47 U.S.C.
309(j)(12)) for the purposes of collecting the information
required for its report under each of subparagraphs (A)
through (E) of such section, and shall keep the Congress
fully and currently informed with respect to the progress of
such inquiry.
Subtitle E--Medicaid
SEC. 3400. TABLE OF CONTENTS OF SUBTITLE; REFERENCES.
(a) Table of Contents of Subtitle.--The table of contents
of this subtitle is as follows:
Sec. 3400. Table of contents of subtitle; references.
Chapter 1--State Flexibility
SUBCHAPTER A--USE OF MANAGED CARE
Sec. 3401. State options to provide benefits through managed care
entities.
Sec. 3402. Elimination of 75:25 restriction on risk contracts.
Sec. 3403. Primary care case management services as State option
without need for waiver.
Sec. 3404. Change in threshold amount for contracts requiring
Secretary's prior approval.
SUBCHAPTER B--PAYMENT METHODOLOGY
Sec. 3411. Flexibility in payment methods for hospital, nursing
facility, and ICF/MR services; flexibility for home
health.
Sec. 3412. Payment for Federally qualified health center services.
Sec. 3413. Treatment of State taxes imposed on certain hospitals that
provide free care.
SUBCHAPTER C--ELIGIBILITY
Sec. 3421. State option of continuous eligibility for 12 months;
clarification of State option to cover children.
[[Page H4420]]
Sec. 3422. Payment of part or all of Medicare part B premium amount for
certain low-income individuals.
Sec. 3423. Penalty for fraudulent eligibility.
Sec. 3424. Treatment of certain settlement payments.
SUBCHAPTER D--PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
Sec. 3431. Establishment of PACE program as medicaid State option.
Sec. 3432. Coverage of PACE under the medicare program.
Sec. 3433. Effective date; transition.
Sec. 3434. Study and reports.
SUBCHAPTER E--BENEFITS
Sec. 3441. Elimination of requirement to pay for private insurance.
Sec. 3442. Permitting same copayments in health maintenance
organizations as in fee-for-service.
Sec. 3443. Physician qualification requirements.
Sec. 3444. Elimination of requirement of prior institutionalization
with respect to habilitation services furnished under a
waiver for home or community-based services.
Sec. 3445. Benefits for services of physician assistants.
Sec. 3446. Study and report on actuarial value of EPSDT benefit.
SUBCHAPTER F--ADMINISTRATION
Sec. 3451. Elimination of duplicative inspection of care requirements
for ICFS/MR and mental hospitals.
Sec. 3452. Alternative sanctions for noncompliant ICFS/MR.
Sec. 3453. Modification of MMIS requirements.
Sec. 3454. Facilitating imposition of State alternative remedies on
noncompliant nursing facilities.
Sec. 3455. Medically accepted indication.
Sec. 3456. Continuation of State-wide section 1115 medicaid waivers.
Sec. 3457. Authorizing administrative streamlining and privatizing
modifications under the medicaid program.
Sec. 3458. Extension of moratorium.
Chapter 2--Quality Assurance
Sec. 3461. Requirements to ensure quality of and access to care under
managed care plans.
Sec. 3462. Solvency standards for certain health maintenance
organizations.
Sec. 3463. Application of prudent layperson standard for emergency
medical condition and prohibition of gag rule
restrictions.
Sec. 3464. Additional fraud and abuse protections in managed care.
Sec. 3465. Grievances under managed care plans.
Sec. 3466. Standards relating to access to obstetrical and
gynecological services under managed care plans.
Chapter 3--Federal Payments
Sec. 3471. Reforming disproportionate share payments under State
medicaid programs.
Sec. 3472. Additional funding for State emergency health services
furnished to undocumented aliens.
(b) Amendments to Social Security Act.--Except as otherwise
specifically provided, whenever in this subtitle an amendment
is expressed in terms of an amendment to or repeal of a
section or other provision, the reference is considered to be
made to that section or other provision of the Social
Security Act.
CHAPTER 1--STATE FLEXIBILITY
Subchapter A--Use of Managed Care
SEC. 3401. STATE OPTIONS TO PROVIDE BENEFITS THROUGH MANAGED
CARE ENTITIES.
(a) In General.--Section 1915(a) (42 U.S.C. 1396n(a)) is
amended--
(1) by striking ``or'' at the end of paragraph (1),
(2) by striking the period at the end of paragraph (2) and
inserting ``; or'', and
(3) by adding at the end the following new paragraph:
``(3) requires individuals, other than special needs
children (as defined in subsection (i)), eligible for medical
assistance for items or services under the State plan to
enroll with an entity that provides or arranges for services
for enrollees under a contract pursuant to section 1903(m),
or with a primary care case manager (as defined in section
1905(t)(2)) (or restricts the number of provider agreements
with those entities under the State plan, consistent with
quality of care), if--
``(A) the State permits an individual to choose the manager
or managed care entity from among the managed care
organizations and primary care case providers who meet the
requirements of this title;
``(B)(i) individuals are permitted to choose between at
least 2 of those entities, or 2 of the managers, or an entity
and a manager, each of which has sufficient capacity to
provide services to enrollees; or
``(ii) with respect to a rural area--
``(I) individuals who are required to enroll with a single
entity are afforded the option to obtain covered services by
an alternative provider; and
``(II) an individual who is offered no alternative to a
single entity or manager is given a choice between at least
two providers within the entity or through the manager;
``(C) no individual who is an Indian (as defined in section
4 of the Indian Health Care Improvement Act of 1976) is
required to enroll in any entity that is not one of the
following (and only if such entity is participating under the
plan): the Indian Health Service, an Indian health program
operated by an Indian tribe or tribal organization pursuant
to a contract, grant, cooperative agreement, or compact with
the Indian Health Service pursuant to the Indian Self-
Determination Act (25 U.S.C. 450 et seq.), or an urban Indian
health program operated by an urban Indian organization
pursuant to a grant or contract with the Indian Health
Service pursuant to title V of the Indian Health Care
Improvement Act (25 U.S.C. 1601 et seq.);
``(D) the State restricts those individuals from changing
their enrollment without cause for periods no longer than six
months (and permits enrollees to change enrollment for cause
at any time);
``(E) the restrictions do not apply to providers of family
planning services (as defined in section 1905(a)(4)(C)) and
are not conditions for payment of medicare cost sharing
pursuant to section 1905(p)(3); and
``(F) prior to establishing an enrollment requirement under
this paragraph, the State agency provides for public notice
and comment pursuant to requirements established by the
Secretary.''.
(b) Special Needs Children Defined.--Section 1915 (42
U.S.C. 1396n) is amended by adding at the end the following:
``(i) For purposes of subsection (a)(3), the term `special
needs child' means an individual under 19 years of age who--
``(1) is eligible for supplemental security income under
title XVI,
``(2) is described in section 501(a)(1)(D),
``(3) is described in section 1902(e)(3), or
``(4) is in foster care or otherwise in an out-of-home
placement.''.
(c) Conforming Amendment to Risk-Based Arrangements.--
Section 1903(m)(2) (42 U.S.C. 1396b(m)(2)) is amended--
(1) in paragraph (A)(vi)--
(A) by striking ``(I) except as provided under subparagraph
(F),''; and
(B) by striking all that follows ``to terminate such
enrollment'' and inserting ``in accordance with the
provisions of subparagraph (F);''; and
(2) in subparagraph (F)--
(A) by striking ``In the case of--'' and all that follows
through ``a State plan'' and inserting ``A State plan'', and
(B) by striking ``(A)(vi)(I)'' and inserting ``(A)(vi)''.
(d) Effective Date.--The amendments made by this section
take effect on the date of the enactment of this Act.
SEC. 3402. ELIMINATION OF 75:25 RESTRICTION ON RISK
CONTRACTS.
(a) 75 Percent Limit on Medicare and Medicaid Enrollment.--
(1) In general.--Section 1903(m)(2)(A) (42 U.S.C.
1396b(m)(2)(A)) is amended by striking clause (ii).
(2) Conforming amendments.--Section 1903(m)(2) (42 U.S.C.
1396b(m)(2)) is amended--
(A) by striking subparagraphs (C), (D), and (E); and
(B) in subparagraph (G), by striking ``clauses (i) and
(ii)'' and inserting ``clause (i)''.
(b) Effective Date.--The amendments made by subsection (a)
take effect on the date of the enactment of this Act.
SEC. 3403. PRIMARY CARE CASE MANAGEMENT SERVICES AS STATE
OPTION WITHOUT NEED FOR WAIVER.
(a) Optional Coverage as Part of Medical Assistance.--
Section 1905(a) (42 U.S.C. 1396d(a)) is amended--
(1) by striking ``and'' at the end of paragraph (24);
(2) by redesignating paragraph (25) as paragraph (26) and
by striking the period at the end of such paragraph and
inserting a comma; and
(3) by inserting after paragraph (24) the following new
paragraph:
``(25) primary care case management services (as defined in
subsection (t)); and''.
(b) Primary Care Case Management Services Defined.--Section
1905 (42 U.S.C. 1396d) is amended by adding at the end the
following new subsection:
``(t)(1) The term `primary care case management services'
means case-management related services (including
coordination and monitoring of health care services) provided
by a primary care case manager under a primary care case
management contract.
``(2)(A) The term `primary care case manager' means, with
respect to a primary care case management contract, a
provider described in subparagraph (B).
``(B) A provider described in this subparagraph is a
provider that provides primary care case management services
under contract and is--
``(i) a physician, a physician group practice, or an entity
employing or having other arrangements with physicians; or
``(ii) at State option--
``(I) a nurse practitioner (as described in section
1905(a)(21));
``(II) a certified nurse-midwife (as defined in section
1861(gg)); or
``(III) a physician assistant (as defined in section
1861(aa)(5)).
``(3) The term `primary care case management contract'
means a contract with a State agency under which a primary
care case manager undertakes to locate, coordinate and
monitor covered primary care (and
[[Page H4421]]
such other covered services as may be specified under the
contract) to all individuals enrolled with the primary care
case manager, and which provides for--
``(A) reasonable and adequate hours of operation, including
24-hour availability of information, referral, and treatment
with respect to medical emergencies;
``(B) restriction of enrollment to individuals residing
sufficiently near a service delivery site of the entity to be
able to reach that site within a reasonable time using
available and affordable modes of transportation;
``(C) employment of, or contracts or other arrangements
with, sufficient numbers of physicians and other appropriate
health care professionals to ensure that services under the
contract can be furnished to enrollees promptly and without
compromise to quality of care;
``(D) a prohibition on discrimination on the basis of
health status or requirements for health services in
enrollment, disenrollment, or reenrollment of individuals
eligible for medical assistance under this title; and
``(E) a right for an enrollee to terminate enrollment
without cause during the first month of each enrollment
period, which period shall not exceed six months in duration,
and to terminate enrollment at any time for cause.
``(4) For purposes of this subsection, the term `primary
care' includes all health care services customarily provided
in accordance with State licensure and certification laws and
regulations, and all laboratory services customarily provided
by or through, a general practitioner, family medicine
physician, internal medicine physician, obstetrician/
gynecologist, or pediatrician.''.
(c) Conforming Amendments.--Section 1902 (42 U.S.C. 1396a)
is amended--
(1) in subsection (a)(10)(C)(iv), by striking ``(24)'' and
inserting ``(25)'', and
(2) in subsection (j), by striking ``(25)'' and inserting
``(26)''.
(d) Effective Date.--The amendments made by this section
apply to primary care case management services furnished on
or after October 1, 1997.
SEC. 3404. CHANGE IN THRESHOLD AMOUNT FOR CONTRACTS REQUIRING
SECRETARY'S PRIOR APPROVAL.
(a) In General.--Section 1903(m)(2)(A)(iii) (42 U.S.C.
1396b(m)(2)(A)(iii)) is amended by striking ``$100,000'' and
inserting ``$1,000,000 for 1998 and, for a subsequent year,
the amount established under this clause for the previous
year increased by the percentage increase in the consumer
price index for all urban consumers over the previous year''.
(b) Effective Date.--The amendment made by subsection (a)
shall apply to contracts entered into or renewed on or after
the date of the enactment of this Act.
Subchapter B--Payment Methodology
SEC. 3411. FLEXIBILITY IN PAYMENT METHODS FOR HOSPITAL,
NURSING FACILITY, AND ICF/MR SERVICES;
FLEXIBILITY FOR HOME HEALTH.
(a) Repeal of Boren Requirements.--Section 1902(a)(13) (42
U.S.C. 1396a(a)) is amended--
(1) by amending subparagraphs (A) and (B) to read as
follows:
``(A) for a public process for determination of rates of
payment under the plan for hospital services, nursing
facility services, and services of intermediate care
facilities for the mentally retarded under which--
``(i) proposed rates are published, and providers,
beneficiaries and their representatives, and other concerned
State residents are given a reasonable opportunity for review
and comment on the proposed rates;
``(ii) final rates are published, together with
justifications, and
``(iii) in the case of hospitals, take into account (in a
manner consistent with section 1923) the situation of
hospitals which serve a disproportionate number of low income
patients with special needs;
``(B) that the State shall provide assurances satisfactory
to the Secretary that the average level of payments under the
plan for nursing facility services (as determined on an
aggregate per resident-day basis) and the level of payments
under the plan for inpatient hospital services (as determined
on an aggregate hospital payment basis) furnished during the
18-month period beginning October 1, 1997, is not less than
the average level of payments that would be made under the
plan during such 18-month period for such respective services
(determined on such basis) based on rates or payment basis in
effect as of May 1, 1997;''; and
(2) by striking subparagraph (C).
(b) Repeal of Requirements Relating to Home Health
Services.--Such section is further amended--
(1) by adding ``and'' at the end of subparagraph (D),
(2) by striking ``and'' at the end of subparagraph (E), and
(3) by striking subparagraph (F).
(c) Effective Date.--The amendments made by this section
shall apply to payment for items and services furnished on or
after the date of the enactment of this Act.
SEC. 3412. PAYMENT FOR CENTER AND CLINIC SERVICES.
(a) Phase-Out of Payment Based on Reasonable Costs.--
Section 1902(a)(13)(E) (42 U.S.C. 1396a(a)(13)(E)) is amended
by inserting ``(or 95 percent for services furnished during
fiscal year 2000, 90 percent for service furnished during
fiscal year 2001, and 85 percent for services furnished
during fiscal year 2002)'' after ``100 percent''.
(b) Transitional Supplemental Payment for Services
Furnished Under Certain Managed Care Contracts.--
(1) In general.--Section 1902(a)(13)(E) is further
amended--
(A) by inserting ``(i)'' after ``(E)'', and
(B) by inserting before the semicolon at the end the
following: ``and (ii) in carrying out clause (i) in the case
of services furnished by a federally qualified health center
or a rural health clinic pursuant to a contract between the
center and a health maintenance organization under section
1903(m), for payment by the State of a supplemental payment
equal to the amount (if any) by which the amount determined
under clause (i) exceeds the amount of the payments provided
under such contract''.
(2) Conforming amendment to managed care contract
requirement.--Clause (ix) of section 1903(m)(2)(A) (42 U.S.C.
1396b(m)(2)(A)) is amended to read as follows:
``(ix) such contract provides, in the case of an entity
that has entered into a contract for the provision of
services with a federally qualified health center or a rural
health clinic, that the entity shall provide payment that is
not less than the level and amount of payment which the
entity would make for the services if the services were
furnished by a provider which is not a federally qualified
health center or a rural health clinic;''.
(3) Effective date.--The amendments made by this section
shall apply to services furnished on or after October 1,
1997.
(c) End of Transitional Payment Rules.--Effective for
services furnished on or after October 1, 2002--
(1) subparagraph (E) of section 1902(a)(13) (42 U.S.C.
1396a(a)(13)) is repealed, and
(2) clause (ix) of section 1903(m)(2)(A) (42 U.S.C.
1396b(m)(2)(A)) is repealed.
(d) Flexibility in Coverage of Non-Freestanding Look-
Alikes.--
(1) In general.--Section 1905(l)(2)(B)(iii) (42 U.S.C.
1396d(l)(2)(B)(iii)) is amended by inserting ``and is not
other than an entity that is owned, controlled, or operated
by another provider'' after ``such a grant''.
(2) Effective date.--The amendments made by paragraph (1)
shall apply to service furnished on and after the date of the
enactment of this Act.
(e) GAO Report.--By not later than February 1, 2001, the
Comptroller General shall submit to Congress a report on the
impact of the amendments made by this section on access to
health care for medicaid beneficiaries and the uninsured
served at health centers and rural health clinics and the
ability of health centers and rural health clinics to become
integrated in a m
Major Actions:
All articles in House section
BALANCED BUDGET ACT OF 1997
(House of Representatives - June 25, 1997)
Text of this article available as:
[Pages H4416-H4606]
[[Page H4416]]
BALANCED BUDGET ACT OF 1997
Mr. KASICH. Mr. Speaker, pursuant to House Resolution 174, I call up
the bill (H.R. 2015) to provide for reconciliation pursuant to
subsections (b)(1) and (c) of section 105 of the concurrent resolution
on the budget for fiscal year 1998, and ask for its immediate
consideration.
The Clerk read the title of the bill.
The SPEAKER pro tempore (Mr. Dreier). Pursuant to House Resolution
174, the amendment printed in the Congressional Record numbered 1 is
adopted.
The text of H.R. 2015, as amended, is as follows:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Balanced Budget Act of
1997''.
SEC. 2. TABLE OF CONTENTS.
Title I--Committee on Agriculture.
Title II--Committee on Banking and Financial Services.
Title III--Committee on Commerce--Nonmedicare.
Title IV--Committee on Commerce--Medicare.
Title V--Committee on Education and the Workforce.
Tittle VI--Committee on Government Reform and Oversight.
Title VII--Committee on Transportation and Infrastructure.
Title VIII--Committee on Veterans' Affairs.
Title IX--Committee on Ways and Means--Nonmedicare.
Title X--Committee on Ways and Means--Medicare.
Title XI--Budget Enforcement.
TITLE I--COMMITTEE ON AGRICULTURE
SEC. 1001. EXEMPTION.
Section 6(o) of the Food Stamp Act of 1977 (7 U.S.C.
2015(o)) is amended--
(1) in paragraph (2)(D), by striking ``or (5)'' and
inserting ``(5), or (6)'';
(2) by redesignating paragraphs (5) and (6) as paragraphs
(6) and (7), respectively; and
(3) by inserting after paragraph (4) the following new
paragraph:
``(5) 15-percent exemption.--
``(A) Definitions.--In this paragraph:
``(i) Caseload.--The term `caseload' means the average
monthly number of individuals receiving food stamps during
the 12-month period ending the preceding June 30.
``(ii) Covered individual.--The term `covered individual'
means a food stamp recipient, or an individual denied
eligibility for food stamp benefits solely due to paragraph
(2), who--
``(I) is not eligible for an exception under paragraph (3);
``(II) does not reside in an area covered by a waiver
granted under paragraph (4);
``(III) is not complying with subparagraph (A), (B), or (C)
of paragraph (2);
``(IV) is not in the first 3 months of eligibility under
paragraph (2); and
``(V) is not receiving benefits under paragraph (6).
``(B) General rule.--Subject to subparagraphs (C) through
(F), a State agency may provide an exemption from the
requirements of paragraph (2) for covered individuals.
``(C) Fiscal year 1998.--Subject to subparagraph (E), for
fiscal year 1998, a State agency may provide a number of
exemptions such that the average monthly number of the
exemptions in effect during the fiscal year does not exceed
15 percent of the number of covered individuals in the State
in fiscal year 1998, as estimated by the Secretary, based on
the survey conducted to carry out section 16(c) for fiscal
year 1996 and such other factors as the Secretary considers
appropriate due to the timing and limitations of the survey.
``(D) Subsequent fiscal years.--Subject to subparagraphs
(E) and (F), for fiscal year 1999 and each subsequent fiscal
year, a State agency may provide a number of exemptions such
that the average monthly number of the exemptions in effect
during the fiscal year does not exceed 15 percent of the
number of covered individuals in the State, as estimated by
the Secretary under subparagraph (C), adjusted by the
Secretary to reflect changes in the State's caseload and the
Secretary's estimate of changes in the proportion of food
stamp recipients covered by waivers granted under paragraph
(4).
``(E) Caseload adjustments.--The Secretary shall adjust the
number of individuals estimated for a State under
subparagraph (C) or (D) during a fiscal year if the number of
food stamp recipients in the State varies by a significant
number from the caseload, as determined by the Secretary.
``(F) Exemption adjustments.--During fiscal year 1999 and
each subsequent fiscal year, the Secretary shall increase or
decrease the number of individuals who may be granted an
exemption by a State agency to the extent that the average
monthly number of exemptions in effect in the State for the
preceding fiscal year is greater or less than the average
monthly number of exemptions estimated for the State agency
during such preceding fiscal year.
``(G) Reporting requirement.--A State agency shall submit
such reports to the Secretary as the Secretary determines are
necessary to ensure compliance with this paragraph.''.
SEC. 1002. ADDITIONAL FUNDING FOR EMPLOYMENT AND TRAINING.
(a) In General.--Section 16(h) of the Food Stamp Act of
1977 (7 U.S.C. 2025(h)) is amended--
(1) by striking paragraph (1) and inserting the following
new paragraph:
``(1) In general.--
``(A) Amounts.--To carry out employment and training
programs, the Secretary shall reserve for allocation to State
agencies, to remain available until expended, from funds made
available for each fiscal year under section 18(a)(1) the
amount of--
``(i) for fiscal year 1996, $75,000,000;
``(ii) for fiscal year 1997, $79,000,000;
``(iii) for fiscal year 1998, $221,000,000;
``(iv) for fiscal year 1999, $224,000,000;
``(v) for fiscal year 2000, $226,000,000;
``(vi) for fiscal year 2001, $228,000,000; and
``(vii) for fiscal year 2002, $210,000,000.
``(B) Limitations.--The Secretary shall ensure that--
``(i) the funds provided in this subparagraph shall not be
used for food stamp recipients who receive benefits under a
State program funded under part A of title IV of the Social
Security Act (42 U.S.C. 601 et seq.); and
``(ii) not less than 80 percent of the funds provided in
this subparagraph shall be used by a State agency for
employment and training programs under section 6(d)(4), other
than job search or job search training programs, for food
stamp recipients not excepted by section 6(o)(3).
``(C) Allocation.--
``(i) Allocation formula.--The Secretary shall allocate the
amounts reserved under subparagraph (A) among the State
agencies using a reasonable formula, as determined and
adjusted by the Secretary each fiscal year, to reflect
changes in each State's caseload (as defined in section
6(o)(5)(A)) that reflects the proportion of food stamp
recipients who reside in each State--
``(I) who are not eligible for an exception under section
6(o)(3); and
``(II) who do not reside in an area subject to the waiver
granted by the Secretary under section 6(o)(4), if the State
agency does not provide employment and training services in
the area to food stamp recipients not excepted by section
6(o)(3).
``(ii) Reporting requirement.--A State agency shall submit
such reports to the Secretary as the Secretary determines are
necessary to ensure compliance with this paragraph.''; and
``(D) Reallocation.--
``(i) Notification.--A State agency shall promptly notify
the Secretary if the State agency determines that it will not
expend all of the funds allocated to it under subparagraph
(B).
``(ii) Reallocation.--On notification under clause (i), the
Secretary shall reallocate the funds that the State agency
will not expend as the Secretary considers appropriate and
equitable.
``(E) Minimum allocation.--Notwithstanding subparagraphs
(A) through (C), the Secretary shall ensure that each State
agency operating an employment and training program shall
receive not less than $50,000 for each fiscal year.
``(F) Maintenance of effort.--To receive the additional
funding under subparagraph (A), as provided by the amendment
made by section 1002 of the Balanced Budget Act of 1997, a
State agency shall maintain the expenditures of the State
agency for employment and training programs and workfare
programs for any fiscal year under paragraph (2), and
administrative expenses under section 20(g)(1), at a level
that is not less than the level of the expenditures by the
State agency to carry out the programs for fiscal year
1996.'';
(2) by redesignating paragraphs (2) through (5) as
paragraphs (3) through (6), respectively;
(3) by inserting after paragraph (1) the following new
paragraph:
``(2) Report to congress on additional funding.--Beginning
one year after the date of the enactment of this paragraph,
the Secretary shall submit an annual report to the Committee
on Agriculture of the House of Representatives and the
Committee on Agriculture, Nutrition, and Forestry of the
Senate regarding whether the additional funding provided
under paragraph (1)(A) has been utilized by State agencies to
increase the number of work slots in their employment and
training programs and workfare for recipients subject to
section 6(o) in the most efficient and effective manner.'';
and
(4) in paragraph (3) (as so redesignated), by striking
``paragraph (3)'' and inserting ``paragraph (4)''.
(b) Conforming Amendments.--(1) Subsection
(b)(1)(B)(iv)(III)(hh) of section 17 of the Food Stamp Act of
1977 (7 U.S.C. 2026) is amended by striking ``(h)(2), or
(h)(3) of section 16'' and inserting ``(h)(3), or (h)(4) of
section 16''.
(2) Subsection (d)(1)(B)(ii) of section 22 of such Act (7
U.S.C. 2031) is amended by striking ``(h)(2), and (h)(3) of
section 16'' and inserting ``(h)(3), and (h)(4) of section
16''.
SEC. 1003. AUTHORIZING USE OF NONGOVERNMENTAL PERSONNEL IN
MAKING DETERMINATIONS OF ELIGIBILITY FOR
BENEFITS UNDER THE FOOD STAMP PROGRAM.
(a) In General.--Notwithstanding any other provision of
law, no provision of law shall be construed as preventing any
State (as defined in section 3(m) of the Food Stamp Act of
1977 (7 U.S.C. 2012(m))) from allowing eligibility
determinations described in subsection (b) to be made by an
entity that is not a State or local government, or by an
individual who is not an employee of a State or
[[Page H4417]]
local government, which meets such qualifications as the
State determines. For purposes of any Federal law, such
determinations shall be considered to be made by the State
and by a State agency.
(b) Eligibility Determinations.--An eligibility
determination described in this subsection is a determination
of eligibility of individuals or households to receive
benefits under the food stamp program as defined in section
3(h) of the Food Stamp Act of 1977 (7 U.S.C. 2012(h)).
(c) Construction.--Nothing in this section shall be
construed as affecting--
(1) the conditions for eligibility for benefits (including
any conditions relating to income or resources);
(2) the rights to challenge determinations regarding
eligibility or rights to benefits; and
(3) determinations regarding quality control or error
rates.
TITLE II--COMMITTEE ON BANKING AND FINANCIAL SERVICES
SEC. 2001. TABLE OF CONTENTS.
The table of contents for this title is as follows:
TITLE II--COMMITTEE ON BANKING AND FINANCIAL SERVICES
Sec. 2001. Table of contents.
Sec. 2002. Extension of foreclosure avoidance and borrower assistance
provisions for FHA single family housing mortgage
insurance program.
Sec. 2003. Adjustment of maximum monthly rents for certain dwelling
units in new construction and substantial or moderate
rehabilitation projects assisted under section 8 rental
assistance program.
Sec. 2004. Adjustment of maximum monthly rents for non-turnover
dwelling units assisted under section 8 rental assistance
program.
SEC. 2002. EXTENSION OF FORECLOSURE AVOIDANCE AND BORROWER
ASSISTANCE PROVISIONS FOR FHA SINGLE FAMILY
HOUSING MORTGAGE INSURANCE PROGRAM.
Section 407 of The Balanced Budget Downpayment Act, I (12
U.S.C. 1710 note) is amended--
(1) in subsection (c)--
(A) by striking ``only''; and
(B) by inserting ``, on, or after'' after ``before''; and
(2) by striking subsection (e).
SEC. 2003. ADJUSTMENT OF MAXIMUM MONTHLY RENTS FOR CERTAIN
DWELLING UNITS IN NEW CONSTRUCTION AND
SUBSTANTIAL OR MODERATE REHABILITATION PROJECTS
ASSISTED UNDER SECTION 8 RENTAL ASSISTANCE
PROGRAM.
The third sentence of section 8(c)(2)(A) of the United
States Housing Act of 1937 (42 U.S.C. 1437f(c)(2)(A)) is
amended by inserting before the period at the end the
following: ``, and during fiscal year 1999 and thereafter''.
SEC. 2004. ADJUSTMENT OF MAXIMUM MONTHLY RENTS FOR NON-
TURNOVER DWELLING UNITS ASSISTED UNDER SECTION
8 RENTAL ASSISTANCE PROGRAM.
The last sentence of section 8(c)(2)(A) of the United
States Housing Act of 1937 is amended by inserting before the
period at the end the following: ``, and during fiscal year
1999 and thereafter''.
TITLE III--COMMITTEE ON COMMERCE-NONMEDICARE
Subtitle A--Nuclear Regulatory Commission Annual Charges
SEC. 3001. NUCLEAR REGULATORY COMMISSION ANNUAL CHARGES.
Section 6101(a)(3) of the Omnibus Budget Reconciliation Act
of 1990 (42 U.S.C. 2214(a)(3)) is amended by striking
``September 30, 1998'' and inserting ``September 30, 2002''.
Subtitle B--Lease of Excess Strategic Petroleum Reserve Capacity
SEC. 3101. LEASE OF EXCESS STRATEGIC PETROLEUM RESERVE
CAPACITY.
(a) Amendment.--Part B of title I of the Energy Policy and
Conservation Act (42 U.S.C. 6231 et seq.) is amended by
adding at the end the following:
``USE OF UNDERUTILIZED FACILITIES
``Sec. 168. (a) Authority.--Notwithstanding any other
provision of this title, the Secretary, by lease or
otherwise, for any term and under such other conditions as
the Secretary considers necessary or appropriate, may store
in underutilized Strategic Petroleum Reserve facilities
petroleum product owned by a foreign government or its
representative. Petroleum products stored under this section
are not part of the Strategic Petroleum Reserve and may be
exported without license from the United States.
``(b) Protection of Facilities.--All agreements entered
into pursuant to subsection (a) shall contain provisions
providing for fees to fully compensate the United States for
all costs of storage and removals of petroleum products,
including the cost of replacement facilities necessitated as
a result of any withdrawals.
``(c) Access to Stored Oil.--The Secretary shall ensure
that agreements to store petroleum products for foreign
governments or their representatives do not affect the
ability of the United States to withdraw, distribute, or sell
petroleum from the Strategic Petroleum Reserve in response to
an energy emergency or to the obligations of the United
States under the Agreement on an International Energy
Program.
``(d) Availability of Funds.--Funds collected through the
leasing of Strategic Petroleum Reserve facilities authorized
by subsection (a) after September 30, 2002, shall be used by
the Secretary of Energy without further appropriation for the
purchase of oil for, and operation and maintenance costs of,
the Strategic Petroleum Reserve.''.
(b) Table of Contents Amendment.--The table of contents of
part B of title I of the Energy Policy and Conservation Act
is amended by adding at the end the following:
``Sec. 168. Use of underutilized facilities.''.
Subtitle C--Sale of DOE Assets
SEC. 3201. SALE OF DOE SURPLUS URANIUM ASSETS.
(a) In General.--The Secretary of Energy shall, during the
period fiscal year 1999 through fiscal year 2002, sell 3.2
million pounds per year of natural and low-enriched uranium
that the President has determined is not necessary for
national security needs. Such sales shall be--
(1) made for delivery after January 1, 1999;
(2) subject to a determination, for the period fiscal year
1999 through fiscal year 2002, by the Secretary under section
3112(d)(2)(B) of the USEC Privatization Act (42 U.S.C. 2297h-
10(d)(2)(B)); and
(3) made at a price not less than the fair market value of
the uranium and in a manner that maximizes proceeds to the
Treasury.
The Secretary shall receive the proceeds from such sale in
the period fiscal year 1999 through fiscal year 2002 and
shall deposit such proceeds in the General Fund of the
Treasury.
(b) Costs.--The costs of making the sales required by
subsection (a) shall be covered by the unobligated balances
of appropriations of the Department of Energy.
Subtitle D--Communications
SEC. 3301. SPECTRUM AUCTIONS.
(a) Extension and Expansion of Auction Authority.--
(1) Amendments.--Section 309(j) of the Communications Act
of 1934 (47 U.S.C. 309(j)) is amended--
(A) by striking paragraphs (1) and (2) and inserting in
lieu thereof the following:
``(1) General authority.--If, consistent with the
obligations described in paragraph (6)(E), mutually exclusive
applications are accepted for any initial license or
construction permit which will involve an exclusive use of
the electromagnetic spectrum, then the Commission shall grant
such license or permit to a qualified applicant through a
system of competitive bidding that meets the requirements of
this subsection.
``(2) Exemptions.--The competitive bidding authority
granted by this subsection shall not apply to licenses or
construction permits issued by the Commission--
``(A) that, as the result of the Commission carrying out
the obligations described in paragraph (6)(E), are not
mutually exclusive;
``(B) for public safety radio services, including private
internal radio services used by non-Government entities,
that--
``(i) protect the safety of life, health, or property; and
``(ii) are not made commercially available to the public;
``(C) for initial licenses or construction permits assigned
by the Commission to existing terrestrial broadcast licensees
for new terrestrial digital television services; or
``(D) for public telecommunications services, as defined in
section 397(14) of the Communications Act of 1934 (47 U.S.C.
397(14)), when the license application is for channels
reserved for noncommercial use.'';
(B) in paragraph (3)--
(i) by inserting after the second sentence the following
new sentence: ``The Commission shall, directly or by
contract, provide for the design and conduct (for purposes of
testing) of competitive bidding using a contingent
combinatorial bidding system that permits prospective bidders
to bid on combinations or groups of licenses in a single bid
and to enter multiple alternative bids within a single
bidding round.'';
(ii) by striking ``and'' at the end of subparagraph (C);
(iii) by striking the period at the end of subparagraph (D)
and inserting ``; and''; and
(iv) by adding at the end the following new subparagraph:
``(E) ensuring that, in the scheduling of any competitive
bidding under this subsection, an adequate period is
allowed--
``(i) before issuance of bidding rules, to permit notice
and comment on proposed auction procedures; and
``(ii) after issuance of bidding rules, to ensure that
interested parties have a sufficient time to develop business
plans, assess market conditions, and evaluate the
availability of equipment for the relevant services.'';
(C) in paragraph (4)--
(i) by striking ``and'' at the end of subparagraph (D);
(ii) by striking the period at the end of subparagraph (E)
and inserting ``; and''; and
(iii) by adding at the end the following new subparagraph:
``(F) establish methods by which a minimum bid, in an
amount that is more than nominal in relation to the value of
the public spectrum resource being made available, will be
required to obtain any license or permit being assigned
pursuant to the competitive bidding.'';
(D) in paragraph (8)--
(i) by striking subparagraph (B); and
(ii) by redesignating subparagraph (C) as subparagraph (B);
(E) in paragraph (11), by striking ``September 30, 1998''
and inserting ``December 31, 2002''; and
[[Page H4418]]
(F) in paragraph (13)(F), by striking ``September 30,
1998'' and inserting ``the date of enactment of the Balanced
Budget Act of 1997''.
(2) Conforming amendment.--Subsection (i) of section 309 of
the Communications Act of 1934 (47 U.S.C. 309(i)) is
repealed.
(3) Effective date.--The amendment made by paragraph (1)(A)
shall not apply with respect to any license or permit for
which the Federal Communications Commission has accepted
mutually exclusive applications on or before the date of
enactment of this Act.
(b) Commission Obligation To Make Additional Spectrum
Available by Auction.--
(1) In general.--The Federal Communications Commission
shall complete all actions necessary to permit the
assignment, by September 30, 2002, by competitive bidding
pursuant to section 309(j) of the Communications Act of 1934
(47 U.S.C. 309(j)) of licenses for the use of bands of
frequencies that--
(A) individually span not less than 25 megahertz, unless a
combination of smaller bands can, notwithstanding the
provisions of paragraph (7) of such section, reasonably be
expected to produce greater receipts;
(B) in the aggregate span not less than 100 megahertz;
(C) are located below 3 gigahertz;
(D) have not, as of the date of enactment of this Act--
(i) been designated by Commission regulation for assignment
pursuant to such section;
(ii) been identified by the Secretary of Commerce pursuant
to section 113 of the National Telecommunications and
Information Administration Organization Act;
(iii) been allocated for Federal Government use pursuant to
section 305 of the Communications Act of 1934 (47 U.S.C.
305);
(iv) been designated in section 3303 of this Act; or
(v) been allocated for unlicensed use pursuant to part 15
of the Commission's regulations (47 C.F.R. Part 15), if the
competitive bidding for licenses would interfere with
operation of end-user products permitted under such
regulations;
(E) notwithstanding section 115(b)(1)(B) of the National
Telecommunications and Information Administration
Organization Act (47 U.S.C. 925(b)(1)(B)) or any proposal
pursuant to such section, include frequencies at 1,710-1,755
megahertz;
(F) include frequencies at 2,110-2,150 megahertz; and
(G) include 15 megahertz from within the bands of
frequencies at 1,990-2,110 megahertz.
(2) Schedule for assignment of 1,710-1,755 megahertz.--The
Commission shall commence competitive bidding for the
commercial licenses pursuant to paragraph (1)(E) after
January 1, 2001. The Commission shall complete the assignment
of such commercial licenses, and report to the Congress the
total revenues from such competitive bidding, by September
30, 2002.
(3) Use of bands at 2,110-2,150 megahertz.--The Commission
shall reallocate spectrum located at 2,110-2,150 megahertz
for assignment by competitive bidding unless the Commission
determines that auction of other spectrum (A) better serves
the public interest, convenience, and necessity, and (B) can
reasonably be expected to produce greater receipts. If the
Commission makes such a determination, then the Commission
shall, within 2 years after the date of enactment of this
Act, identify an alternative 40 megahertz, and report to the
Congress an identification of such alternative 40 megahertz
for assignment by competitive bidding.
(4) Use of 15 megahertz from bands at 1,990-2,110
megahertz.--The Commission shall reallocate 15 megahertz from
spectrum located at 1,990-2,110 megahertz for assignment by
competitive bidding unless the President determines such
spectrum cannot be reallocated due to the need to protect
incumbent Federal systems from interference, and that
allocation of other spectrum (A) better serves the public
interest, convenience, and necessity, and (B) can reasonably
be expected to produce greater receipts. If the President
makes such a determination, then the President shall, within
2 years after the date of enactment of this Act, identify
alternative bands of frequencies totalling 15 megahertz, and
report to the Congress an identification of such alternative
bands for assignment by competitive bidding.
(5) Criteria for reassignment.--In making available bands
of frequencies for competitive bidding pursuant to paragraph
(1), the Commission shall--
(A) seek to promote the most efficient use of the spectrum;
(B) take into account the cost to incumbent licensees of
relocating existing uses to other bands of frequencies or
other means of communication; and
(C) comply with the requirements of international
agreements concerning spectrum allocations.
(6) Notification to ntia.--The Commission shall notify the
Secretary of Commerce if--
(A) the Commission is not able to provide for the effective
relocation of incumbent licensees to bands of frequencies
that are available to the Commission for assignment; and
(B) the Commission has identified bands of frequencies that
are--
(i) suitable for the relocation of such licensees; and
(ii) allocated for Federal Government use, but that could
be reallocated pursuant to part B of the National
Telecommunications and Information Administration
Organization Act (as amended by this Act).
(c) Identification and Reallocation of Frequencies.--The
National Telecommunications and Information Administration
Organization Act (47 U.S.C. 901 et seq.) is amended--
(1) in section 113, by adding at the end the following new
subsection:
``(f) Additional Reallocation Report.--If the Secretary
receives a notice from the Commission pursuant to section
3301(b)(3) of the Balanced Budget Act of 1997, the Secretary
shall prepare and submit to the President, the Commission,
and the Congress a report recommending for reallocation for
use other than by Federal Government stations under section
305 of the 1934 Act (47 U.S.C. 305), bands of frequencies
that are suitable for the uses identified in the Commission's
notice. The Commission shall, not later than one year after
receipt of such report, prepare, submit to the President and
the Congress, and implement, a plan for the immediate
allocation and assignment of such frequencies under the 1934
Act to incumbent licencees described in section 3301(b)(3) of
the Balanced Budget Act of 1997.''; and
(2) in section 114(a)(1), by striking ``(a) or (d)(1)'' and
inserting ``(a), (d)(1), or (f)''.
(d) Identification and Reallocation of Auctionable
Frequencies.--The National Telecommunications and Information
Administration Organization Act (47 U.S.C. 901 et seq.) is
amended--
(1) in section 113(b)--
(A) by striking the heading of paragraph (1) and inserting
``Initial reallocation report'';
(B) by inserting ``in the first report required by
subsection (a)'' after ``recommend for reallocation'' in
paragraph (1);
(C) by inserting ``or (3)'' after ``paragraph (1)'' each
place it appears in paragraph (2); and
(D) by inserting after paragraph (2) the following new
paragraph:
``(3) Second reallocation report.--In accordance with the
provisions of this section, the Secretary shall recommend for
reallocation in the second report required by subsection (a),
for use other than by Federal Government stations under
section 305 of the 1934 Act (47 U.S.C. 305), a band or bands
of frequencies that--
``(A) in the aggregate span not less than 20 megahertz;
``(B) individually span not less than 20 megahertz, unless
a combination of smaller bands can reasonably be expected to
produce greater receipts;
``(C) are located below 3 gigahertz; and
``(D) meet the criteria specified in paragraphs (1) through
(5) of subsection (a).''; and
(2) in section 115--
(A) in subsection (b), by striking ``the report required by
section 113(a)'' and inserting ``the initial reallocation
report required by section 113(a)''; and
(B) by adding at the end the following new subsection:
``(c) Allocation and Assignment of Frequencies Identified
in the Second Reallocation Report.--With respect to the
frequencies made available for reallocation pursuant to
section 113(b)(3), the Commission shall, not later than one
year after receipt of the second reallocation report required
by such section, prepare, submit to the President and the
Congress, and implement, a plan for the immediate allocation
and assignment under the 1934 Act of all such frequencies in
accordance with section 309(j) of such Act.''.
SEC. 3302. AUCTION OF RECAPTURED BROADCAST TELEVISION
SPECTRUM.
Section 309(j) of the Communications Act of 1934 (47 U.S.C.
309(j)) is amended by adding at the end the following new
paragraph:
``(14) Auction of recaptured broadcast television
spectrum.--
``(A) Limitations on terms of terrestrial television
broadcast licenses.--A television license that authorizes
analog television services may not be renewed to authorize
such service for a period that extends beyond December 31,
2006. The Commission shall have the authority to grant by
regulation an extension of such date to licensees in a market
if the Commission determines that more than 5 percent of
households in such market continue to rely exclusively on
over-the-air terrestrial analog television signals.
``(B) Spectrum reversion and resale.--
``(i) The Commission shall ensure that, when the authority
to broadcast analog television services under a license
expires pursuant to subparagraph (A), each licensee shall
return spectrum according to the Commission's direction and
the Commission shall reclaim such spectrum.
``(ii) Licensees for new services occupying spectrum
reclaimed pursuant to clause (i) shall be selected in
accordance with this subsection. The Commission shall
complete the assignment of such licenses, and report to the
Congress the total revenues from such competitive bidding, by
September 30, 2002.
``(C) Certain limitations on qualified bidders
prohibited.--In prescribing any regulations relating to the
qualification of bidders for spectrum reclaimed pursuant to
subparagraph (B)(i), the Commission shall not--
``(i) preclude any party from being a qualified bidder for
spectrum that is allocated for any use that includes digital
television service on the basis of--
``(I) the Commission's duopoly rule (47 C.F.R. 73.3555(b));
or
``(II) the Commission's newspaper cross-ownership rule (47
C.F.R. 73.3555(d)); or
``(ii) apply either such rule to preclude such a party that
is a successful bidder in a
[[Page H4419]]
competitive bidding for such spectrum from using such
spectrum for digital television service.
``(D) Definitions.--As used in this paragraph:
``(i) The term `digital television service' means
television service provided using digital technology to
enhance audio quality and video resolution, as further
defined in the Memorandum Opinion, Report, and Order of the
Commission entitled `Advanced Television Systems and Their
Impact Upon the Existing Television Service', MM Docket No.
87-268 and any subsequent Commission proceedings dealing with
digital television.
``(ii) The term `analog television service' means service
provided pursuant to the transmission standards prescribed by
the Commission in section 73.682(a) of its regulation (47 CFR
73.682(a)).''.
SEC. 3303. ALLOCATION AND ASSIGNMENT OF NEW PUBLIC SAFETY AND
COMMERCIAL LICENSES.
(a) In General.--The Federal Communications Commission
shall, not later than January 1, 1998, allocate on a
national, regional, or market basis, from radio spectrum
between 746 megahertz and 806 megahertz--
(1) 24 megahertz of that spectrum for public safety
services according to the terms and conditions established by
the Commission, unless the Commission determines that the
needs for public safety services can be met in particular
areas with allocations of less than 24 megahertz; and
(2) the remainder of that spectrum for commercial purposes
to be assigned by competitive bidding in accordance with
section 309(j).
(b) Assignment.--The Commission shall--
(1) assign the licenses for public safety created pursuant
to subsection (a) no later than March 31, 1998;
(2) commence competitive bidding for the commercial
licenses created pursuant to subsection (a) after January 1,
2001; and
(3) complete competitive bidding for such commercial
licenses, and report to the Congress the total revenues from
such competitive bidding, by September 30, 2002.
(c) Licensing of Unused Frequencies for Public Safety Radio
Services.--
(1) Use of unused channels for public safety.--It shall be
the policy of the Commission, notwithstanding any other
provision of this Act or any other law, to waive whatever
licensee eligibility and other requirements (including
bidding requirements) are applicable in order to permit the
use of unassigned frequencies for public safety purposes by a
State or local governmental agency upon a showing that--
(A) no other existing satisfactory public safety channel is
immediately available to satisfy the requested use;
(B) the proposed use is technically feasible without
causing harmful interference to existing stations in the
frequency band entitled to protection from such interference
under the rules of the Commission; and
(C) use of the channel for public safety purposes is
consistent with other existing public safety channel
allocations in the geographic area of proposed use.
(2) Applicability.--Paragraph (1) shall apply to any
application that is pending before the Federal Communications
Commission, or that is not finally determined under either
section 402 or 405 of the Communications Act of 1934 (47
U.S.C. 402, 405) on May 15, 1997, or that is filed after such
date.
(d) Conditions on Licenses.--With respect to public safety
and commercial licenses granted pursuant to this subsection,
the Commission shall--
(1) establish interference limits at the boundaries of the
spectrum block and service area;
(2) establish any additional technical restrictions
necessary to protect full-service analog television service
and digital television service during a transition to digital
television service; and
(3) permit public safety and commercial licensees--
(A) to aggregate multiple licenses to create larger
spectrum blocks and service areas; and
(B) to disaggregate or partition licenses to create smaller
spectrum blocks or service areas.
(e) Protection of Qualifying Low-Power Stations.--After
making any allocation or assignment under this section the
Commission shall seek to assure that each qualifying low-
power television station is assigned a frequency below 746
megahertz to permit the continued operation of such station.
(f) Definitions.--For purposes of this section:
(1) Commission.--The term ``Commission'' means the Federal
Communications Commission.
(2) Digital television service.--The term ``digital
television service'' means television service provided using
digital technology to enhance audio quality and video
resolution, as further defined in the Memorandum Opinion,
Report, and Order of the Commission entitled `Advanced
Television Systems and Their Impact Upon the Existing
Television Service', MM Docket No. 87-268 and any subsequent
Commission proceedings dealing with digital television.
(3) Analog television service.--The term ``analog
television service'' means services provided pursuant to the
transmission standards prescribed by the Commission in
section 73.682(a) of its regulation (47 CFR 73.682(a)).
(4) Public safety services.--The term ``public safety
services'' means services--
(A) the sole or principal purpose of which is to protect
the safety of life, health, or property;
(B) that are provided--
(i) by State or local government entities; or
(ii) by nongovernmental, private organizations that are
authorized by a governmental entity whose primary mission is
the provision of such services; and
(C) that are not made commercially available to the public
by the provider.
(5) Service area.--The term ``service area'' means the
geographic area over which a licensee may provide service and
is protected from interference.
(6) Spectrum block.--The term ``spectrum block'' means the
range of frequencies over which the apparatus licensed by the
Commission is authorized to transmit signals.
(7) Qualifying low-power television stations.--A station is
a qualifying low-power television station if, during the 90
days preceding the date of enactment of this Act--
(A) such station broadcast a minimum of 18 hours per day;
(B) such station broadcast an average of at least 3 hours
per week of programming that was produced within the
community of license of such station; and
(C) such station was in compliance with the requirements
applicable to low-power television stations.
SEC. 3304. ADMINISTRATIVE PROCEDURES FOR SPECTRUM AUCTIONS.
(a) Expedited Procedures.--The rules governing competitive
bidding under this subtitle shall be effective immediately
upon publication in the Federal Register notwithstanding
section 553(d), 801(a)(3), and 806(a) of title 5, United
States Code. Chapter 6 of such title, and sections 3507 and
3512 of title 44, United States Code, shall not apply to such
rules and competitive bidding procedures governing
frequencies assigned under this subtitle. Notwithstanding
section 309(b) of the Communications Act of 1934 (47 U.S.C.
309(b)), no application for an instrument of authorization
for such frequencies shall be granted by the Commission
earlier than 7 days following issuance of public notice by
the Commission of the acceptance for filing of such
application or of any substantial amendment thereto.
Notwithstanding section 309(d)(1) of such Act (47 U.S.C.
309(d)(1)), the Commission may specify a period (no less than
5 days following issuance of such public notice) for the
filing of petitions to deny any application for an instrument
of authorization for such frequencies.
(b) Deadline for Collection.--The Commission shall conduct
the competitive bidding under this subtitle in a manner that
ensures that all proceeds of the bidding are deposited in
accordance with section 309(j)(8) of the Communications Act
of 1934 not later September 30, 2002.
SEC. 3305. UNIVERSAL SERVICE FUND PAYMENT SCHEDULE.
(a) Acceleration of Payments.--There shall be available in
fiscal year 2001 from funds in the Treasury not otherwise
appropriated $2,000,000,000 to the universal service fund
under part 54 of the Federal Communications Commission's
regulations (47 C.F.R. Part 54) in addition to any other
revenues required to be collected under such part.
(b) Limitation on Expenditures.--The outlays of the
universal service fund under part 54 of the Federal
Communications Commission's regulations (47 C.F.R. Part 54)
in fiscal year 2002 shall not exceed the amount of revenue
required to be collected in such fiscal year, less
$2,000,000,000.
SEC. 3306. INQUIRY REQUIRED.
The Federal Communications Commission shall, not later than
July 1, 1997, initiate the inquiry required by section
309(j)(12) of the Communications Act of 1934 (47 U.S.C.
309(j)(12)) for the purposes of collecting the information
required for its report under each of subparagraphs (A)
through (E) of such section, and shall keep the Congress
fully and currently informed with respect to the progress of
such inquiry.
Subtitle E--Medicaid
SEC. 3400. TABLE OF CONTENTS OF SUBTITLE; REFERENCES.
(a) Table of Contents of Subtitle.--The table of contents
of this subtitle is as follows:
Sec. 3400. Table of contents of subtitle; references.
Chapter 1--State Flexibility
SUBCHAPTER A--USE OF MANAGED CARE
Sec. 3401. State options to provide benefits through managed care
entities.
Sec. 3402. Elimination of 75:25 restriction on risk contracts.
Sec. 3403. Primary care case management services as State option
without need for waiver.
Sec. 3404. Change in threshold amount for contracts requiring
Secretary's prior approval.
SUBCHAPTER B--PAYMENT METHODOLOGY
Sec. 3411. Flexibility in payment methods for hospital, nursing
facility, and ICF/MR services; flexibility for home
health.
Sec. 3412. Payment for Federally qualified health center services.
Sec. 3413. Treatment of State taxes imposed on certain hospitals that
provide free care.
SUBCHAPTER C--ELIGIBILITY
Sec. 3421. State option of continuous eligibility for 12 months;
clarification of State option to cover children.
[[Page H4420]]
Sec. 3422. Payment of part or all of Medicare part B premium amount for
certain low-income individuals.
Sec. 3423. Penalty for fraudulent eligibility.
Sec. 3424. Treatment of certain settlement payments.
SUBCHAPTER D--PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
Sec. 3431. Establishment of PACE program as medicaid State option.
Sec. 3432. Coverage of PACE under the medicare program.
Sec. 3433. Effective date; transition.
Sec. 3434. Study and reports.
SUBCHAPTER E--BENEFITS
Sec. 3441. Elimination of requirement to pay for private insurance.
Sec. 3442. Permitting same copayments in health maintenance
organizations as in fee-for-service.
Sec. 3443. Physician qualification requirements.
Sec. 3444. Elimination of requirement of prior institutionalization
with respect to habilitation services furnished under a
waiver for home or community-based services.
Sec. 3445. Benefits for services of physician assistants.
Sec. 3446. Study and report on actuarial value of EPSDT benefit.
SUBCHAPTER F--ADMINISTRATION
Sec. 3451. Elimination of duplicative inspection of care requirements
for ICFS/MR and mental hospitals.
Sec. 3452. Alternative sanctions for noncompliant ICFS/MR.
Sec. 3453. Modification of MMIS requirements.
Sec. 3454. Facilitating imposition of State alternative remedies on
noncompliant nursing facilities.
Sec. 3455. Medically accepted indication.
Sec. 3456. Continuation of State-wide section 1115 medicaid waivers.
Sec. 3457. Authorizing administrative streamlining and privatizing
modifications under the medicaid program.
Sec. 3458. Extension of moratorium.
Chapter 2--Quality Assurance
Sec. 3461. Requirements to ensure quality of and access to care under
managed care plans.
Sec. 3462. Solvency standards for certain health maintenance
organizations.
Sec. 3463. Application of prudent layperson standard for emergency
medical condition and prohibition of gag rule
restrictions.
Sec. 3464. Additional fraud and abuse protections in managed care.
Sec. 3465. Grievances under managed care plans.
Sec. 3466. Standards relating to access to obstetrical and
gynecological services under managed care plans.
Chapter 3--Federal Payments
Sec. 3471. Reforming disproportionate share payments under State
medicaid programs.
Sec. 3472. Additional funding for State emergency health services
furnished to undocumented aliens.
(b) Amendments to Social Security Act.--Except as otherwise
specifically provided, whenever in this subtitle an amendment
is expressed in terms of an amendment to or repeal of a
section or other provision, the reference is considered to be
made to that section or other provision of the Social
Security Act.
CHAPTER 1--STATE FLEXIBILITY
Subchapter A--Use of Managed Care
SEC. 3401. STATE OPTIONS TO PROVIDE BENEFITS THROUGH MANAGED
CARE ENTITIES.
(a) In General.--Section 1915(a) (42 U.S.C. 1396n(a)) is
amended--
(1) by striking ``or'' at the end of paragraph (1),
(2) by striking the period at the end of paragraph (2) and
inserting ``; or'', and
(3) by adding at the end the following new paragraph:
``(3) requires individuals, other than special needs
children (as defined in subsection (i)), eligible for medical
assistance for items or services under the State plan to
enroll with an entity that provides or arranges for services
for enrollees under a contract pursuant to section 1903(m),
or with a primary care case manager (as defined in section
1905(t)(2)) (or restricts the number of provider agreements
with those entities under the State plan, consistent with
quality of care), if--
``(A) the State permits an individual to choose the manager
or managed care entity from among the managed care
organizations and primary care case providers who meet the
requirements of this title;
``(B)(i) individuals are permitted to choose between at
least 2 of those entities, or 2 of the managers, or an entity
and a manager, each of which has sufficient capacity to
provide services to enrollees; or
``(ii) with respect to a rural area--
``(I) individuals who are required to enroll with a single
entity are afforded the option to obtain covered services by
an alternative provider; and
``(II) an individual who is offered no alternative to a
single entity or manager is given a choice between at least
two providers within the entity or through the manager;
``(C) no individual who is an Indian (as defined in section
4 of the Indian Health Care Improvement Act of 1976) is
required to enroll in any entity that is not one of the
following (and only if such entity is participating under the
plan): the Indian Health Service, an Indian health program
operated by an Indian tribe or tribal organization pursuant
to a contract, grant, cooperative agreement, or compact with
the Indian Health Service pursuant to the Indian Self-
Determination Act (25 U.S.C. 450 et seq.), or an urban Indian
health program operated by an urban Indian organization
pursuant to a grant or contract with the Indian Health
Service pursuant to title V of the Indian Health Care
Improvement Act (25 U.S.C. 1601 et seq.);
``(D) the State restricts those individuals from changing
their enrollment without cause for periods no longer than six
months (and permits enrollees to change enrollment for cause
at any time);
``(E) the restrictions do not apply to providers of family
planning services (as defined in section 1905(a)(4)(C)) and
are not conditions for payment of medicare cost sharing
pursuant to section 1905(p)(3); and
``(F) prior to establishing an enrollment requirement under
this paragraph, the State agency provides for public notice
and comment pursuant to requirements established by the
Secretary.''.
(b) Special Needs Children Defined.--Section 1915 (42
U.S.C. 1396n) is amended by adding at the end the following:
``(i) For purposes of subsection (a)(3), the term `special
needs child' means an individual under 19 years of age who--
``(1) is eligible for supplemental security income under
title XVI,
``(2) is described in section 501(a)(1)(D),
``(3) is described in section 1902(e)(3), or
``(4) is in foster care or otherwise in an out-of-home
placement.''.
(c) Conforming Amendment to Risk-Based Arrangements.--
Section 1903(m)(2) (42 U.S.C. 1396b(m)(2)) is amended--
(1) in paragraph (A)(vi)--
(A) by striking ``(I) except as provided under subparagraph
(F),''; and
(B) by striking all that follows ``to terminate such
enrollment'' and inserting ``in accordance with the
provisions of subparagraph (F);''; and
(2) in subparagraph (F)--
(A) by striking ``In the case of--'' and all that follows
through ``a State plan'' and inserting ``A State plan'', and
(B) by striking ``(A)(vi)(I)'' and inserting ``(A)(vi)''.
(d) Effective Date.--The amendments made by this section
take effect on the date of the enactment of this Act.
SEC. 3402. ELIMINATION OF 75:25 RESTRICTION ON RISK
CONTRACTS.
(a) 75 Percent Limit on Medicare and Medicaid Enrollment.--
(1) In general.--Section 1903(m)(2)(A) (42 U.S.C.
1396b(m)(2)(A)) is amended by striking clause (ii).
(2) Conforming amendments.--Section 1903(m)(2) (42 U.S.C.
1396b(m)(2)) is amended--
(A) by striking subparagraphs (C), (D), and (E); and
(B) in subparagraph (G), by striking ``clauses (i) and
(ii)'' and inserting ``clause (i)''.
(b) Effective Date.--The amendments made by subsection (a)
take effect on the date of the enactment of this Act.
SEC. 3403. PRIMARY CARE CASE MANAGEMENT SERVICES AS STATE
OPTION WITHOUT NEED FOR WAIVER.
(a) Optional Coverage as Part of Medical Assistance.--
Section 1905(a) (42 U.S.C. 1396d(a)) is amended--
(1) by striking ``and'' at the end of paragraph (24);
(2) by redesignating paragraph (25) as paragraph (26) and
by striking the period at the end of such paragraph and
inserting a comma; and
(3) by inserting after paragraph (24) the following new
paragraph:
``(25) primary care case management services (as defined in
subsection (t)); and''.
(b) Primary Care Case Management Services Defined.--Section
1905 (42 U.S.C. 1396d) is amended by adding at the end the
following new subsection:
``(t)(1) The term `primary care case management services'
means case-management related services (including
coordination and monitoring of health care services) provided
by a primary care case manager under a primary care case
management contract.
``(2)(A) The term `primary care case manager' means, with
respect to a primary care case management contract, a
provider described in subparagraph (B).
``(B) A provider described in this subparagraph is a
provider that provides primary care case management services
under contract and is--
``(i) a physician, a physician group practice, or an entity
employing or having other arrangements with physicians; or
``(ii) at State option--
``(I) a nurse practitioner (as described in section
1905(a)(21));
``(II) a certified nurse-midwife (as defined in section
1861(gg)); or
``(III) a physician assistant (as defined in section
1861(aa)(5)).
``(3) The term `primary care case management contract'
means a contract with a State agency under which a primary
care case manager undertakes to locate, coordinate and
monitor covered primary care (and
[[Page H4421]]
such other covered services as may be specified under the
contract) to all individuals enrolled with the primary care
case manager, and which provides for--
``(A) reasonable and adequate hours of operation, including
24-hour availability of information, referral, and treatment
with respect to medical emergencies;
``(B) restriction of enrollment to individuals residing
sufficiently near a service delivery site of the entity to be
able to reach that site within a reasonable time using
available and affordable modes of transportation;
``(C) employment of, or contracts or other arrangements
with, sufficient numbers of physicians and other appropriate
health care professionals to ensure that services under the
contract can be furnished to enrollees promptly and without
compromise to quality of care;
``(D) a prohibition on discrimination on the basis of
health status or requirements for health services in
enrollment, disenrollment, or reenrollment of individuals
eligible for medical assistance under this title; and
``(E) a right for an enrollee to terminate enrollment
without cause during the first month of each enrollment
period, which period shall not exceed six months in duration,
and to terminate enrollment at any time for cause.
``(4) For purposes of this subsection, the term `primary
care' includes all health care services customarily provided
in accordance with State licensure and certification laws and
regulations, and all laboratory services customarily provided
by or through, a general practitioner, family medicine
physician, internal medicine physician, obstetrician/
gynecologist, or pediatrician.''.
(c) Conforming Amendments.--Section 1902 (42 U.S.C. 1396a)
is amended--
(1) in subsection (a)(10)(C)(iv), by striking ``(24)'' and
inserting ``(25)'', and
(2) in subsection (j), by striking ``(25)'' and inserting
``(26)''.
(d) Effective Date.--The amendments made by this section
apply to primary care case management services furnished on
or after October 1, 1997.
SEC. 3404. CHANGE IN THRESHOLD AMOUNT FOR CONTRACTS REQUIRING
SECRETARY'S PRIOR APPROVAL.
(a) In General.--Section 1903(m)(2)(A)(iii) (42 U.S.C.
1396b(m)(2)(A)(iii)) is amended by striking ``$100,000'' and
inserting ``$1,000,000 for 1998 and, for a subsequent year,
the amount established under this clause for the previous
year increased by the percentage increase in the consumer
price index for all urban consumers over the previous year''.
(b) Effective Date.--The amendment made by subsection (a)
shall apply to contracts entered into or renewed on or after
the date of the enactment of this Act.
Subchapter B--Payment Methodology
SEC. 3411. FLEXIBILITY IN PAYMENT METHODS FOR HOSPITAL,
NURSING FACILITY, AND ICF/MR SERVICES;
FLEXIBILITY FOR HOME HEALTH.
(a) Repeal of Boren Requirements.--Section 1902(a)(13) (42
U.S.C. 1396a(a)) is amended--
(1) by amending subparagraphs (A) and (B) to read as
follows:
``(A) for a public process for determination of rates of
payment under the plan for hospital services, nursing
facility services, and services of intermediate care
facilities for the mentally retarded under which--
``(i) proposed rates are published, and providers,
beneficiaries and their representatives, and other concerned
State residents are given a reasonable opportunity for review
and comment on the proposed rates;
``(ii) final rates are published, together with
justifications, and
``(iii) in the case of hospitals, take into account (in a
manner consistent with section 1923) the situation of
hospitals which serve a disproportionate number of low income
patients with special needs;
``(B) that the State shall provide assurances satisfactory
to the Secretary that the average level of payments under the
plan for nursing facility services (as determined on an
aggregate per resident-day basis) and the level of payments
under the plan for inpatient hospital services (as determined
on an aggregate hospital payment basis) furnished during the
18-month period beginning October 1, 1997, is not less than
the average level of payments that would be made under the
plan during such 18-month period for such respective services
(determined on such basis) based on rates or payment basis in
effect as of May 1, 1997;''; and
(2) by striking subparagraph (C).
(b) Repeal of Requirements Relating to Home Health
Services.--Such section is further amended--
(1) by adding ``and'' at the end of subparagraph (D),
(2) by striking ``and'' at the end of subparagraph (E), and
(3) by striking subparagraph (F).
(c) Effective Date.--The amendments made by this section
shall apply to payment for items and services furnished on or
after the date of the enactment of this Act.
SEC. 3412. PAYMENT FOR CENTER AND CLINIC SERVICES.
(a) Phase-Out of Payment Based on Reasonable Costs.--
Section 1902(a)(13)(E) (42 U.S.C. 1396a(a)(13)(E)) is amended
by inserting ``(or 95 percent for services furnished during
fiscal year 2000, 90 percent for service furnished during
fiscal year 2001, and 85 percent for services furnished
during fiscal year 2002)'' after ``100 percent''.
(b) Transitional Supplemental Payment for Services
Furnished Under Certain Managed Care Contracts.--
(1) In general.--Section 1902(a)(13)(E) is further
amended--
(A) by inserting ``(i)'' after ``(E)'', and
(B) by inserting before the semicolon at the end the
following: ``and (ii) in carrying out clause (i) in the case
of services furnished by a federally qualified health center
or a rural health clinic pursuant to a contract between the
center and a health maintenance organization under section
1903(m), for payment by the State of a supplemental payment
equal to the amount (if any) by which the amount determined
under clause (i) exceeds the amount of the payments provided
under such contract''.
(2) Conforming amendment to managed care contract
requirement.--Clause (ix) of section 1903(m)(2)(A) (42 U.S.C.
1396b(m)(2)(A)) is amended to read as follows:
``(ix) such contract provides, in the case of an entity
that has entered into a contract for the provision of
services with a federally qualified health center or a rural
health clinic, that the entity shall provide payment that is
not less than the level and amount of payment which the
entity would make for the services if the services were
furnished by a provider which is not a federally qualified
health center or a rural health clinic;''.
(3) Effective date.--The amendments made by this section
shall apply to services furnished on or after October 1,
1997.
(c) End of Transitional Payment Rules.--Effective for
services furnished on or after October 1, 2002--
(1) subparagraph (E) of section 1902(a)(13) (42 U.S.C.
1396a(a)(13)) is repealed, and
(2) clause (ix) of section 1903(m)(2)(A) (42 U.S.C.
1396b(m)(2)(A)) is repealed.
(d) Flexibility in Coverage of Non-Freestanding Look-
Alikes.--
(1) In general.--Section 1905(l)(2)(B)(iii) (42 U.S.C.
1396d(l)(2)(B)(iii)) is amended by inserting ``and is not
other than an entity that is owned, controlled, or operated
by another provider'' after ``such a grant''.
(2) Effective date.--The amendments made by paragraph (1)
shall apply to service furnished on and after the date of the
enactment of this Act.
(e) GAO Report.--By not later than February 1, 2001, the
Comptroller General shall submit to Congress a report on the
impact of the amendments made by this section on access to
health care for medicaid beneficiaries and the uninsured
served at health centers and rural health clinics and the
ability of health centers and rural health clinics to become
integra
