. Within 180 days after the date of enactment of this Act, the Surface Transportation Board shall promulgate regulations adopting a simplified dispute resolution mechanism with the following features: (1) In general.--The simplified dispute resolution mechanism will utilize expedited arbitration with a minimum of discovery and may be used to decide disputes between parties involving any matter subject to the jurisdiction of the Board, other than rate reasonableness cases that would be decided under constrained market pricing principles. (2) Applicable standards.--Arbitrators will apply existing legal standards. (3) Mandatory if requested.--Use of the simplified dispute resolution mechanism is required whenever at least one party to the dispute requests. (4) 90-day turnaround.--Arbitrators will issue their decisions within 90 days after being appointed. (5) Payment of costs.--Each party will pay its own costs, and the costs of the arbitration and other administrative costs of arbitration will be shared equally between and among the parties. (6) Decisions private; not precedential.--Except as otherwise provided by the Board, decisions will remain private and will not constitute binding precedent. (7) Decisions binding and enforceable.--Except as otherwise provided in paragraph (8), decisions will be binding and enforceable by the Board. (8) Right to appeal.--Any party will have an unqualified right to appeal any decision to the Board, in which case the Board will decide the matter de novo. In making its decision, the Board may consider the decision of the arbitrator and any evidence and other material developed during the arbitration. (9) Mutual modification.--Any procedure or regulation adopted by the Board with respect to the simplified dispute resolution may be modified or eliminated by mutual agreement of all parties to the dispute. SEC. 9. PROMOTION OF COMPETITIVE RAIL SERVICE OPTIONS. Section 11324 of title 49, United States Code, is amended-- (1) by striking ``and'' in paragraph (4) of subsection (b); (2) by striking ``system.'' in paragraph (5) of subsection (b) and inserting ``system; and''; (3) by adding at the end of subsection (b) the following: ``(6) means and methods to encourage and expand competition between and among rail carriers in the affected region or the national rail system.''; and (4) by inserting after the second sentence in subsection (c) the following: ``The Board may impose conditions to encourage and expand competition between and among rail carriers in the affected region or the national rail system, if such conditions do not cause substantial harm to the benefits of the transaction to the affected carriers or the public.''. SEC. 10. CLARIFICATION OF STB AUTHORITY TO GRANT TEMPORARY ACCESS RELIEF. (a) Section 10705 of title 49, United States Code, is amended by adding at the end thereof the following: ``(d) The Board may grant temporary relief under this section when the Board finds it necessary and appropriate to do so to remedy inadequate service. The authority provided in this section is in addition to the authority of the Board to provide temporary relief under sections 11102 and 11123 of this title.''. (b) Section 11102 of title 49, United States Code, is amended by adding at the end thereof the following: ``(e) The Board may grant temporary relief under subsections (a) and (c) when the Board finds it necessary and appropriate to do so to remedy inadequate service. The authority provided in this section is in addition to the authority of the Board to provide temporary relief under sections 10705 and 11123 of this title.''. (c) Section 11123 of title 49, United States Code, is amended by adding at the end thereof the following: ``(e) The authority provided in this section is in addition to the authority of the Board to provide temporary relief under sections 10705 and 11102 of this title.''. SEC. 11. HOUSEHOLD GOODS COLLECTIVE ACTIVITIES. Section 13703(d) of title 49, United States Code, is amended by inserting ``(other than an agreement affecting only the transportation of household goods, as defined on December 31, 1995)'' after ``agreement'' in the first sentence. SEC. 12. AUTHORIZATION LEVELS. There are authorized to be appropriated to the Surface Transportation Board $16,000,000 for fiscal year 1999, $17,000,000 for fiscal year 2000, $17,555,000 for fiscal year 2001, and $18,129,000 for fiscal year 2002. SEC. 13. CHAIRMAN DESIGNATED WITH SENATE CONFIRMATION. Section 701(c)(1) of title 49, United States Code, is amended by striking ``President'' and inserting ``President, by and with the advice and consent of the Senate,''.

Summary: Surface Transportation Board Reauthorization and Improvement Act of 1999 - Amends Federal transportation law to declare that it is U.S. rail transportation policy to: (1) encourage and promote effective competition within the rail industry; and (2) discourage artificial barriers to interchange and car supply which can impede competition between shortline, regional, and Class I carriers and block effective rail service to shippers. (Sec. 3) Extends from 30 days to 60 days (including an additional 60 day extension, but no longer than 18 months unless the Board requests an extension from Congress) the period of time that the Surface Transportation Board may direct the handling, routing, and movement of rail carrier traffic during emergency situations involving congestion of traffic, unauthorized cessation of operations, or other failure of traffic movement. (Sec. 4) Directs the Board to: (1) review rules and procedures applicable to rate complaints and other complaints filed with it by small shippers; and (2) identify, and reduce or eliminate, any such rules or procedures that are unduly burdensome to them; and (3) notify specified congressional committees that such changes in the rules and procedures are appropriate. (Sec. 5) Prohibits the Board from considering evidence of product or geographic competition when making market dominance determinations in rail rate proceedings. (Sec. 6) Amends U.S. rail transportation policy to eliminate a requirement that the Board make a determination with respect to what are adequate revenues for rail carriers in the promotion of a safe and efficient rail transportation system. Requires the Board, in order to facilitate the process by which it gives due consideration to the policy that rail carriers shall earn adequate revenues, to convene a three-member panel of outside experts to make recommendations as to an appropriate methodology by which the adequacy of a carrier's revenues should be considered. (Sec. 7) Provides for situations in which a shipper and rail carrier enter into a contract for transportation that requires a through route with the connecting carrier and there is no reasonable alternative route that can be constructed without the connecting carrier' participation. Requires a connecting carrier in such a situation, upon request, to establish a through route and a contract rate (bottleneck rate) for such transportation unless the connecting carrier shows that: (1) the interchange requested is not operationally feasible; or (2) the through route would significantly impair the connecting carrier's ability to serve its other traffic. Requires contract rate complaints to be limited to the rate that applies to the portion of the through route not governed by the contract. (Sec. 8) Directs the Board to promulgate regulations adopting a simplified dispute resolution mechanism that will expedite (with a minimum of discovery) the arbitration of disputes before the Board (other than rate reasonableness cases that would be decided under constrained market pricing principles). (Sec. 9) Requires the Board, in proceedings which involve the merger or control of at least two Class I railroads, to consider, among other things, means and methods to encourage and expand competition between and among rail carriers in the affected region or the national rail system. Authorizes the Board to impose conditions to encourage and expand such competition, provided that they do not cause substantial harm to the benefits of the transaction to the affected carriers or the public. (Sec. 10) Authorizes the Board to grant temporary access relief to a rail carrier to through routes or terminal facilities in order to remedy inadequate rail service. (Sec. 11) Excludes agreements affecting only the transportation of household goods from the requirement that Board approval of route and rate agreements between motor carriers expire within three years of such approval unless renewed. (Sec. 12) Authorizes appropriations. (Sec. 13) Requires Senate confirmation with respect to the appointment of the Board Chairman.


SECTION 1. BATTERY RECHARGING STATIONS FOR PRIVATELY OWNED VEHICLES IN PARKING AREAS UNDER THE JURISDICTION OF THE HOUSE OF REPRESENTATIVES AT NO NET COST TO THE FEDERAL GOVERNMENT. (a) Definition.--In this Act, the term ``covered employee'' means-- (1) an employee whose pay is disbursed by the Chief Administrative Officer of the House of Representatives; or (2) any other individual who is authorized to park in any parking area under the jurisdiction of the House of Representatives on Capitol Grounds. (b) Authority.-- (1) In general.--Subject to paragraph (3), funds appropriated to the Architect of the Capitol under the heading ``Capitol Power Plant'' under the heading ``ARCHITECT OF THE CAPITOL'' in any fiscal year are available to construct, operate, and maintain on a reimbursable basis battery recharging stations in parking areas under the jurisdiction of the House of Representatives on Capitol Grounds for use by privately owned vehicles used by Members of the House of Representatives (including the Delegates or Resident Commissioner to the Congress) or covered employees. (2) Vendors authorized.--In carrying out paragraph (1), the Architect of the Capitol may use 1 or more vendors on a commission basis. (3) Approval of construction.--The Architect of the Capitol may construct or direct the construction of battery recharging stations described under paragraph (1) after-- (A) submission of written notice detailing the numbers and locations of the battery recharging stations to the Committee on House Administration of the House of Representatives; and (B) approval by that Committee. (c) Fees and Charges.-- (1) In general.--Subject to paragraph (2), the Architect of the Capitol shall charge fees or charges for electricity provided to Members and covered employees sufficient to cover the costs to the Architect of the Capitol to carry out this section, including costs to any vendors or other costs associated with maintaining the battery recharging stations. (2) Approval of fees or charges.--The Architect of the Capitol may establish and adjust fees or charges under paragraph (1) after-- (A) submission of written notice detailing the amount of the fee or charge to be established or adjusted to the Committee on House Administration of the House of Representatives; and (B) approval by that Committee. (d) Deposit and Availability of Fees, Charges, and Commissions.-- Any fees, charges, or commissions collected by the Architect of the Capitol under this section shall be-- (1) deposited in the Treasury to the credit of the appropriations account described under subsection (b); and (2) available for obligation without further appropriation during-- (A) the fiscal year collected; and (B) the fiscal year following the fiscal year collected. (e) Reports.-- (1) In general.--Not later than 30 days after the end of each fiscal year, the Architect of the Capitol shall submit a report on the financial administration and cost recovery of activities under this section with respect to that fiscal year to the Committee on House Administration of the House of Representatives. (2) Avoiding subsidy.-- (A) Determination.--Not later than 3 years after the date of enactment of this Act and every 3 years thereafter, the Architect of the Capitol shall submit a report to the Committee on House Administration of the House of Representatives determining whether Members (including any Delegate or Resident Commissioner to Congress) and covered employees using battery charging stations as authorized by this Act are receiving a subsidy from the taxpayers. (B) Modification of rates and fees.--If a determination is made under subparagraph (A) that a subsidy is being received, the Architect of the Capitol shall submit a plan to the Committee on House Administration of the House of Representatives on how to update the program to ensure no subsidy is being received. If the committee does not act on the plan within 60 days, the Architect of the Capitol shall take appropriate steps to increase rates or fees to ensure reimbursement for the cost of the program consistent with an appropriate schedule for amortization, to be charged to those using the charging stations. (f) Effective Date.--This Act shall apply with respect to fiscal year 2011 and each fiscal year thereafter. Speaker of the House of Representatives. Vice President of the United States and President of the Senate.

Summary: Makes funds appropriated to the Architect of the Capitol (AOC) for the Capitol power plant in any fiscal year available to construct, operate, and maintain on a reimbursable basis battery recharging stations in parking areas under the jurisdiction of the House of Representatives on Capitol grounds for use by privately owned vehicles used by: (1) Members of the House, or (2) employees whose pay is disbursed by the Chief Administrative Officer of the House or any other individuals authorized to park in any parking area under House jurisdiction on Capitol grounds (covered employees). Requires the Architect to charge Members and covered employees fees for the electricity sufficient to cover costs, including those to any vendors or other costs associated with maintaining the battery recharging stations. Requires the AOC to report triennially to the Committee on House Administration on whether or not individuals using the battery charging stations receive a subsidy from the taxpayers, and, if so, to submit a plan to the Committee to update the program to ensure that no subsidy is being received. Requires the AOC, if the Committee fails to act on the plan within 60 days, to take appropriate steps to increase rates or fees to ensure reimbursement for the cost of the program.


SECTION 1. SHORT TITLE. This Act may be cited as the ``Traumatic Brain Injury Act of 2008''. SEC. 2. CONFORMING AMENDMENTS RELATING TO RESTRUCTURING. Part J of title III of the Public Health Service Act (42 U.S.C. 280b et seq.) is amended-- (1) by redesignating the section 393B (42 U.S.C. 280b-1c) relating to the use of allotments for rape prevention education, as section 393A and moving such section so that it follows section 393; (2) by redesignating existing section 393A (42 U.S.C. 280b- 1b) relating to prevention of traumatic brain injury, as section 393B; and (3) by redesignating the section 393B (42 U.S.C. 280b-1d) relating to traumatic brain injury registries, as section 393C. SEC. 3. TRAUMATIC BRAIN INJURY PROGRAMS OF THE CENTERS FOR DISEASE CONTROL AND PREVENTION. (a) Prevention of Traumatic Brain Injury.--Clause (ii) of section 393B(b)(3)(A) of the Public Health Service Act, as so redesignated, (42 U.S.C. 280b-1b) is amended by striking ``from hospitals and trauma centers'' and inserting ``from hospitals and emergency departments''. (b) National Program for Traumatic Brain Injury Surveillance and Registries.--Section 393C of the Public Health Service Act, as so redesignated, (42 U.S.C. 280b et seq.) is amended-- (1) in the section heading, by inserting ``surveillance and'' after ``national program for traumatic brain injury''; and (2) in subsection (a), in the matter preceding paragraph (1), by striking ``may make grants'' and all that follows through ``to collect data concerning--'' and inserting ``may make grants to States or their designees to develop or operate the State's traumatic brain injury surveillance system or registry to determine the incidence and prevalence of traumatic brain injury and related disability, to ensure the uniformity of reporting under such system or registry, to link individuals with traumatic brain injury to services and supports, and to link such individuals with academic institutions to conduct applied research that will support the development of such surveillance systems and registries as may be necessary. A surveillance system or registry under this section shall provide for the collection of data concerning--''. (c) Report.--Section 393C of the Public Health Service Act (as so redesignated) is amended by adding at the end the following: ``(b) Not later than 18 months after the date of enactment of the Traumatic Brain Injury Act of 2008, the Secretary, acting through the Director of the Centers for Disease Control and Prevention and the Director of the National Institutes of Health and in consultation with the Secretary of Defense and the Secretary of Veterans Affairs, shall submit to the relevant committees of Congress a report that contains the findings derived from an evaluation concerning activities and procedures that can be implemented by the Centers for Disease Control and Prevention to improve the collection and dissemination of compatible epidemiological studies on the incidence and prevalence of traumatic brain injury in those with traumatic brain injury who were formerly in the military. The report shall include recommendations on the manner in which such agencies can further collaborate on the development and improvement of traumatic brain injury diagnostic tools and treatments.''. SEC. 4. STUDY ON TRAUMATIC BRAIN INJURY. Part J of title III of the Public Health Service Act (42 U.S.C. 280b et seq.) is amended by inserting after section 393C, as so redesignated, the following: ``SEC. 393C-1. STUDY ON TRAUMATIC BRAIN INJURY. ``(a) Study.--The Secretary, acting through the Director of the Centers for Disease Control and Prevention with respect to paragraph (1) and in consultation with the Director of the National Institutes of Health and other appropriate entities with respect to paragraphs (2), (3), and (4), may conduct a study with respect to traumatic brain injury for the purpose of carrying out the following: ``(1) In collaboration with appropriate State and local health-related agencies-- ``(A) determining the incidence of traumatic brain injury and prevalence of traumatic brain injury related disability and the clinical aspects of the disability in all age groups and racial and ethnic minority groups in the general population of the United States, including institutional settings, such as nursing homes, correctional facilities, psychiatric hospitals, child care facilities, and residential institutes for people with developmental disabilities; and ``(B) reporting national trends in traumatic brain injury. ``(2) Identifying common therapeutic interventions which are used for the rehabilitation of individuals with such injuries, and, subject to the availability of information, including an analysis of-- ``(A) the effectiveness of each such intervention in improving the functioning, including return to work or school and community participation, of individuals with brain injuries; ``(B) the comparative effectiveness of interventions employed in the course of rehabilitation of individuals with brain injuries to achieve the same or similar clinical outcome; and ``(C) the adequacy of existing measures of outcomes and knowledge of factors influencing differential outcomes. ``(3) Identifying interventions and therapies that can prevent or remediate the development of secondary neurologic conditions related to traumatic brain injury. ``(4) Developing practice guidelines for the rehabilitation of traumatic brain injury at such time as appropriate scientific research becomes available. ``(b) Dates Certain for Reports.--If the study is conducted under subsection (a), the Secretary shall, not later than 3 years after the date of the enactment of the Traumatic Brain Injury Act of 2008, submit to Congress a report describing findings made as a result of carrying out such subsection (a). ``(c) Definition.--For purposes of this section, the term `traumatic brain injury' means an acquired injury to the brain. Such term does not include brain dysfunction caused by congenital or degenerative disorders, nor birth trauma, but may include brain injuries caused by anoxia due to trauma including near drowning. The Secretary may revise the definition of such term as the Secretary determines necessary.''. SEC. 5. TRAUMATIC BRAIN INJURY PROGRAMS OF THE NATIONAL INSTITUTES OF HEALTH. Section 1261 of the Public Health Service Act (42 U.S.C. 300d-61) is amended-- (1) in subsection (b)(2), by striking ``Labor and Human Resources'' and inserting ``Health, Education, Labor, and Pensions''; (2) in subparagraph (D) of subsection (d)(4), by striking ``head brain injury'' and inserting ``brain injury''; and (3) in subsection (i), by inserting ``, and such sums as may be necessary for each of the fiscal years 2009 through 2012'' before the period at the end. SEC. 6. TRAUMATIC BRAIN INJURY PROGRAMS OF THE HEALTH RESOURCES AND SERVICES ADMINISTRATION. (a) State Grants for Demonstration Projects Regarding Traumatic Brain Injury.--Section 1252 of the Public Health Service Act (42 U.S.C. 300d-52) is amended-- (1) in subsection (a)-- (A) by striking ``may make grants to States'' and inserting ``may make grants to States and American Indian consortia''; and (B) by striking ``health and other services'' and inserting ``rehabilitation and other services''; (2) in subsection (b)-- (A) in paragraphs (1), (3)(A)(i), (3)(A)(iii), and (3)(A)(iv), by striking the term ``State'' each place such term appears and inserting the term ``State or American Indian consortium''; and (B) in paragraph (2), by striking ``recommendations to the State'' and inserting ``recommendations to the State or American Indian consortium''; (3) in subsection (c)(1), by striking the term ``State'' each place such term appears and inserting ``State or American Indian consortium''; (4) in subsection (e), by striking ``A State that received'' and all that follows through the period and inserting ``A State or American Indian consortium that received a grant under this section prior to the date of the enactment of the Traumatic Brain Injury Act of 2008 may complete the activities funded by the grant.''; (5) in subsection (f)-- (A) in the subsection heading, by inserting ``and American Indian Consortium'' after ``State''; (B) in paragraph (1) in the matter preceding subparagraph (A), paragraph (1)(E), paragraph (2)(A), paragraph (2)(B), paragraph (3) in the matter preceding subparagraph (A), paragraph (3)(E), and paragraph (3)(F), by striking the term ``State'' each place such term appears and inserting ``State or American Indian consortium''; and (C) in clause (ii) of paragraph (1)(A), by striking ``children and other individuals'' and inserting ``children, youth, and adults''; (6) in subsection (h)-- (A) by striking ``Not later than 2 years after the date of the enactment of this section, the Secretary'' and inserting ``Not less than biennially, the Secretary''; (B) by striking ``Commerce of the House of Representatives, and to the Committee on Labor and Human Resources'' and inserting ``Energy and Commerce of the House of Representatives, and to the Committee on Health, Education, Labor, and Pensions''; and (C) by inserting ``and section 1253'' after ``programs established under this section,''; (7) by amending subsection (i) to read as follows: ``(i) Definitions.--For purposes of this section: ``(1) The terms `American Indian consortium' and `State' have the meanings given to those terms in section 1253. ``(2) The term `traumatic brain injury' means an acquired injury to the brain. Such term does not include brain dysfunction caused by congenital or degenerative disorders, nor birth trauma, but may include brain injuries caused by anoxia due to trauma. The Secretary may revise the definition of such term as the Secretary determines necessary, after consultation with States and other appropriate public or nonprofit private entities.''; and (8) in subsection (j), by inserting ``, and such sums as may be necessary for each of the fiscal years 2009 through 2012'' before the period. (b) State Grants for Protection and Advocacy Services.--Section 1253 of the Public Health Service Act (42 U.S.C. 300d-53) is amended-- (1) in subsections (d) and (e), by striking the term ``subsection (i)'' each place such term appears and inserting ``subsection (l)''; (2) in subsection (g), by inserting ``each fiscal year not later than October 1,'' before ``the Administrator shall pay''; (3) by redesignating subsections (i) and (j) as subsections (l) and (m), respectively; (4) by inserting after subsection (h) the following: ``(i) Data Collection.--The Administrator of the Health Resources and Services Administration and the Commissioner of the Administration on Developmental Disabilities shall enter into an agreement to coordinate the collection of data by the Administrator and the Commissioner regarding protection and advocacy services. ``(j) Training and Technical Assistance.-- ``(1) Grants.--For any fiscal year for which the amount appropriated to carry out this section is $6,000,000 or greater, the Administrator shall use 2 percent of such amount to make a grant to an eligible national association for providing for training and technical assistance to protection and advocacy systems. ``(2) Definition.--In this subsection, the term `eligible national association' means a national association with demonstrated experience in providing training and technical assistance to protection and advocacy systems. ``(k) System Authority.--In providing services under this section, a protection and advocacy system shall have the same authorities, including access to records, as such system would have for purposes of providing services under subtitle C of the Developmental Disabilities Assistance and Bill of Rights Act of 2000.''; and (5) in subsection (l) (as redesignated by this subsection) by striking ``2002 through 2005'' and inserting ``2009 through 2012''.

Summary: Traumatic Brain Injury Act of 2008 - (Sec. 3) Amends the Public Health Service Act to revise the national program for traumatic brain injury registries to make grants for state traumatic brain injury surveillance systems or registries (currently, only for registries) to: (1) determine the incidence and prevalence of traumatic brain injury and related disability; (2) ensure the uniformity of reporting under each such system or registry; (3) link individuals with traumatic brain injury to services and supports; and (4) link such individuals with academic institutions to conduct applied research. Requires the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention (CDC) and the Director of the National Institutes of Health (NIH), to report to the relevant congressional committees on activities and procedures that can be implemented by the CDC to improve the collection and dissemination of compatible epidemiological studies on the incidence and prevalence of traumatic brain injury in those who were formerly in the military. (Sec. 4) Authorizes the Secretary, acting through the Director of CDC, to conduct a study to: (1) determine the incidence of traumatic brain injury and prevalence of traumatic brain injury related disability; (2) report national trends in traumatic brain injury; (3) identify common therapeutic interventions which are used for the rehabilitation of individuals with such injuries; (4) identify interventions and therapies that can prevent or remediate the development of secondary neurologic conditions related to traumatic brain injury; and (5) develop practice guidelines for such rehabilitation. (Sec. 5) Authorizes appropriations for FY2009-FY2012 for NIH's trauma research program. (Sec. 6) Allows the Secretary, acting through the Administrator of the Health Resources Services Administration (HRSA), to make grants to states and American Indian consortia (currently, only to states) to improve access to rehabilitation and other services (currently, to health and other services) regarding traumatic brain injury. Authorizes appropriations for such grants for FY2009-FY2012. Requires the Administrator and the Commissioner of the Administration on Developmental Disabilities to coordinate the collection of data regarding protection and advocacy services. Directs the Administrator to make a grant for training and technical assistance to protection and advocacy systems, if funds permit. Authorizes appropriations for FY2009-FY2012.


SECTION 1. SHORT TITLE. This Act may be cited as the ``Alternatives to Opioids (ALTO) in the Emergency Department Act''. SEC. 2. FINDINGS. The Congress finds as follows: (1) Opioids contributed to the deaths of more than 42,000 people in 2016, more than any year on official record. Forty percent of all opioid overdose deaths involve a prescription opioid. (2) The economic burden of prescription opioid misuse in the United States is estimated to be $78,500,000,000 per year. This includes costs stemming from health care, including addiction treatment, lost productivity, and criminal justice involvement. (3) Over 200 million opioid prescriptions are written in the United States each year, and 2,000,000 Americans have the symptoms of substance use disorder. (4) Approximately 21 to 29 percent of patients prescribed opioids for chronic pain misuse them. (5) Emergency departments in several States, including in New Jersey and Colorado, have developed innovative programs to more widely utilize non-opioid pain treatments to reduce the use of opioids. SEC. 3. EMERGENCY DEPARTMENT ALTERNATIVES TO OPIOIDS DEMONSTRATION PROGRAM. (a) Demonstration Program Grants.--The Secretary of Health and Human Services acting through the Assistant Secretary for Mental Health and Substance Use (in this section referred to as the ``Secretary'') shall carry out a 3-year demonstration program under which the Secretary shall award grants to eligible hospitals and emergency departments, including freestanding emergency departments, to develop, implement, enhance, or study alternative pain management protocols and treatments that promote the appropriate limited use of opioids in emergency departments. (b) Eligibility.--To be eligible to receive a grant under subsection (a), a hospital or emergency department shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require. (c) Geographic Diversity.--In awarding grants under this section, the Secretary shall seek to ensure geographical diversity among grant recipients. (d) Use of Funds.--In addition to the activities described in subsection (a), grants under this section shall be used to-- (1) target common painful conditions, which may include renal colic, sciatica, headaches, musculoskeletal pain, and extremity fractures; (2) train providers and other hospital personnel on protocols and use of treatments that promote the appropriate limited use of opioids in the emergency department; (3) collect data, including data required for the reporting requirement established under subsection (f); and (4) provide alternatives to opioids to patients with painful conditions, not including patients who present with pain related to cancer, end-of-life symptom palliation, or complex multisystem trauma. (e) Duties of the Secretary.--The Secretary shall offer to each recipient of a grant under subsection (a) technical support through a process that provides for-- (1) the provision of information by the Secretary on alternative pain management protocols and treatments, which may include-- (A) non-opioid medications; (B) protocols and treatments that do not involve a medication; (C) alternative pain management protocols and treatments that are appropriate to use for specific common painful conditions, such as renal colic, back pain, pain from fractures, and other common painful conditions that present to the emergency department; (D) the alternative pain management protocol or treatments, if any, that are appropriate for certain patient populations, such as geriatric patients, pregnant patients, and pediatric patients; and (E) any other information the Secretary determines necessary; and (2) the provision of information by emergency departments and providers that have successfully implemented alternatives to opioids programs in the emergency department, promoting non- opioid protocols and medications while appropriately limiting the use of opioids. (f) Report to the Secretary.--Each recipient of a grant under this section shall submit to the Secretary annual evaluations of the progress of the program funded through the grant. These evaluations shall include-- (1) a description of and specific information about the alternative pain management protocols and treatments employed; (2) data on the alternative pain management protocols and treatments employed, including-- (A) during a baseline period before the program began, as defined by the Secretary; (B) at various stages of the program, as determined by the Secretary; (C) the conditions for which the alternative pain management protocols and treatments were employed; and (D) data on patients' self-reported pain rating, using a pain scale model provided by the Secretary, before and after the alternative pain management protocol or treatment was provided; (3) data on the opioid prescriptions written, including-- (A) during a baseline period before the program began, as defined by the Secretary; (B) at various stages of the program, as determined by the Secretary; (C) the conditions for which the opioids were prescribed; and (D) data on patients' self-reported pain rating, using a pain scale model provided by the Secretary, before and after the opioid prescription was provided; (4) the demographic characteristics of patients who were treated with an alternative pain management protocol, including age, sex, race, ethnicity, and insurance status and type; (5) data on patients who were eventually prescribed opioids after alternative pain management protocols and treatments were employed; (6) data on patients who were transitioned to inpatient care following treatment with an alternative pain management protocol and treatment; and (7) any other information the Secretary deems necessary. (g) Report to Congress.--Not later than 120 days after completion of the demonstration program under this section, the Secretary shall submit a report to the Congress on the results of the demonstration program and include in the report-- (1) the number of applications received and the number funded; (2) a summary of the evaluations described in subsection (f), including standardized data; and (3) recommendations for broader implementation of pain management protocols that limit the use of opioids in emergency departments or other areas of the health care delivery system. (h) Authorization of Appropriations.--To carry out this section, there is authorized to be appropriated $10,000,000 for each of fiscal years 2019 through 2021.

Summary: Alternatives to Opioids (ALTO) in the Emergency Department Act This bill requires the Department of Health and Human Services to carry out a three-year demonstration program awarding grants to hospitals and emergency departments to develop, implement, enhance, or study alternative pain management protocols and treatments that promote limited use of opioids in emergency departments.


SECTION 1. SHORT TITLE. This Act may be cited as the ``Minority Business Development Improvements Act of 2009''. SEC. 2. MINORITY BUSINESS DEVELOPMENT PROGRAM. The Director of the Minority Business Development Agency shall establish the Minority Business Development Program (hereinafter in this Act referred to as the ``Program'') to assist qualified minority businesses. The Program shall provide to such businesses the following: (1) Technical assistance. (2) Loan guarantees. (3) Contract procurement assistance. SEC. 3. QUALIFIED MINORITY BUSINESS. (a) Certification.--For purposes of the Program, the Director may certify as a qualified minority business any entity that satisfies each of the following: (1) Not less than 51 percent of the entity is directly and unconditionally owned or controlled by historically disadvantaged individuals. (2) Each officer or other individual who exercises control over the regular operations of the entity is a historically disadvantaged individual. (3) The net worth of each principal of the entity is not greater than $2,000,000. (The equity of a disadvantaged owner in a primary personal residence shall be considered in this calculation.) (4) The principal place of business of the entity is in the United States. (5) Each principal of the entity maintains good character in the determination of the Director. (6) The entity engages in competitive and bona fide commercial business operations in not less than one sector of industry that has a North American Industry Classification System code. (7) The entity submits reports to the Director at such time, in such form, and containing such information as the Director may require. (8) Any additional requirements that the Director determines appropriate. (b) Term of Certification.--A certification under this section shall be for a term of 5 years and may not be renewed. SEC. 4. TECHNICAL ASSISTANCE. (a) In General.--In carrying out the Program, the Director may provide to qualified minority businesses technical assistance with regard to the following: (1) Writing business plans. (2) Marketing. (3) Management. (4) Securing sufficient financing for business operations. (b) Contract Authority.--The Director may enter into agreements with persons to provide technical assistance under this section. (c) Authorization of Appropriations.--There are authorized to be appropriated $200,000,000 to the Director to carry out this section. Such sums shall remain available until expended. SEC. 5. LOAN GUARANTEES. (a) In General.--Subject to subsection (b), the Director may guarantee up to 90 percent of the amount of a loan made to a qualified minority business to be used for business purposes, including the following: (1) Purchasing essential equipment. (2) Payroll expenses. (3) Purchasing facilities. (4) Renovating facilities. (b) Terms and Conditions.-- (1) In general.--The Director may make guarantees under this section for projects on such terms and conditions as the Director determines appropriate, after consultation with the Secretary of the Treasury, in accordance with this section. (2) Repayment.--No guarantee shall be made under this section unless the Director determines that there is reasonable prospect of repayment of the principal and interest on the obligation by the borrower. (3) Defaults.-- (A) Payment by director.-- (i) In general.--If a borrower defaults on the obligation (as defined in regulations promulgated by the Director and specified in the guarantee contract), the holder of the guarantee shall have the right to demand payment of the unpaid amount from the Director. (ii) Payment required.--Within such period as may be specified in the guarantee or related agreements, the Director shall pay to the holder of the guarantee the unpaid interest on, and unpaid principal of the obligation as to which the borrower has defaulted, unless the Director finds that there was no default by the borrower in the payment of interest or principal or that the default has been remedied. (iii) Forbearance.--Nothing in this paragraph precludes any forbearance by the holder of the obligation for the benefit of the borrower which may be agreed upon by the parties to the obligation and approved by the Director. (B) Subrogation.-- (i) In general.--If the Director makes a payment under subparagraph (A), the Director shall be subrogated to the rights of the recipient of the payment as specified in the guarantee or related agreements including, where appropriate, the authority (notwithstanding any other provision of law) to-- (I) complete, maintain, operate, lease, or otherwise dispose of any property acquired pursuant to such guarantee or related agreements; or (II) permit the borrower, pursuant to an agreement with the Director, to continue to pursue the purposes of the project if the Director determines this to be in the public interest. (ii) Superiority of rights.--The rights of the Director, with respect to any property acquired pursuant to a guarantee or related agreements, shall be superior to the rights of any other person with respect to the property. (iii) Terms and conditions.--A guarantee agreement shall include such detailed terms and conditions as the Director determines appropriate to-- (I) protect the interests of the United States in the case of default; and (II) have available all the patents and technology necessary for any person selected, including the Director, to complete and operate the project. (C) Payment of principal and interest by director.--With respect to any obligation guaranteed under this section, the Director may enter into a contract to pay, and pay, holders of the obligation, for and on behalf of the borrower, from funds appropriated for that purpose, the principal and interest payments which become due and payable on the unpaid balance of the obligation if the Director finds that-- (i)(I) the borrower is unable to meet the payments and is not in default; (II) it is in the public interest to permit the borrower to continue to pursue the purposes of the project; and (III) the probable net benefit to the Federal Government in paying the principal and interest will be greater than that which would result in the event of a default; (ii) the amount of the payment that the Director is authorized to pay shall be no greater than the amount of principal and interest that the borrower is obligated to pay under the agreement being guaranteed; and (iii) the borrower agrees to reimburse the Director for the payment (including interest) on terms and conditions that are satisfactory to the Director. (D) Action by attorney general.-- (i) Notification.--If the borrower defaults on an obligation, the Director shall notify the Attorney General of the default. (ii) Recovery.--On notification, the Attorney General shall take such action as is appropriate to recover the unpaid principal and interest due from-- (I) such assets of the defaulting borrower as are associated with the obligation; or (II) any other security pledged to secure the obligation. (4) Fees.-- (A) In general.--The Director shall charge and collect fees for guarantees in amounts the Director determines are sufficient to cover applicable administrative expenses, not to exceed 1 percent of the amount guaranteed. (B) Availability.--Fees collected under this paragraph shall-- (i) be deposited by the Director into the Treasury; and (ii) remain available until expended, subject to such other conditions as are contained in annual appropriations Acts. (c) Credit Requirements.--To receive a loan guaranteed under this section a qualified minority business shall-- (1) be in good standing with regard to the credit of that business in the determination of the Director; (2) have received technical assistance under section 4; and (3) submit reports, at such time, in such form, and containing such information as the Director may require regarding the credit of the business. (d) Limits on Guarantee Amounts.-- (1) Maximum amount of guarantee.--The Director may guarantee not more than $450,000 of any loan under this section. (2) Maximum gross loan amount.--A loan guaranteed under this section may not be for a gross loan amount in excess of $500,000. (e) Authorization of Appropriations.--There are authorized to be appropriated to the Director not more than $500,000,000 to carry out this section during fiscal years 2011 through 2016. SEC. 6. SET-ASIDE CONTRACTING OPPORTUNITIES. (a) In General.--The Director may enter into agreements with the United States Government and any department, agency, or officer thereof having procurement powers for purposes of providing for the fulfillment of procurement contracts and providing opportunities for qualified minority businesses with regard to such contracts. (b) Qualifications on Participation.--The Director shall by rule establish requirements for participation under this section by a qualified minority business in a contract. (c) Annual Limit on Number of Contracts Per Qualified Minority Business.--A qualified minority business may not participate under this section in contracts in an amount that exceeds $10,000,000 for goods and services each fiscal year. (d) Limits on Contract Amounts.-- (1) Goods and services.--Except as provided in paragraph (2), a contract for goods and services under this section may not exceed $6,000,000. (2) Manufacturing and construction.--A contract for manufacturing and construction services under this section may not exceed $10,000,000. SEC. 7. TERMINATION FROM THE PROGRAM. The Director may terminate a qualified minority business from the Program for any violation of a requirement of sections 3 through 6 of this Act by that qualified minority business, including the following: (1) Conduct by a principal of the qualified minority business that indicates a lack of business integrity. (2) Willful failure to comply with applicable labor standards and obligations. (3) Consistent failure to tender adequate performance with regard to contracts under the Program. (4) Failure to obtain and maintain relevant certifications. (5) Failure to pay outstanding obligations owed to the Federal Government. SEC. 8. REPORTS. (a) Report of the Director.--Not later than October 1, 2011, and annually thereafter, the Director shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Commerce, Science, and Transportation of the Senate a report describing the activities of the Director during the preceding year with respect to the Program. (b) Report of the Secretary of Commerce.--Not later than October 1, 2011, and annually thereafter, the Secretary of Commerce shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Commerce, Science, and Transportation of the Senate a report describing the activities the Secretary engaged in during the preceding year to build wealth among historically disadvantaged individuals. SEC. 9. DEFINITIONS. In this Act: (1) The term ``historically disadvantaged individual'' means any individual who is a member of a group that is designated as eligible to receive assistance under section 1400.1 of title 15 of the Code of Federal Regulations, as in effect on January 1, 2009. (2) The term ``principal'' means any person that the Director determines to exercise significant control over the regular operations of a business entity.

Summary: Minority Business Development Improvements Act of 2009 - Requires the Director of the Minority Business Development Agency to establish the Minority Business Development Program to provide qualified minority businesses with technical assistance, loan guarantees, and contract procurement assistance. Outlines minority business qualification requirements for the Program, including that: (1) not less than 51% of the entity be directly and unconditionally owned by historically disadvantaged individuals; and (2) each officer or other individual exercising control over regular operations is a historically disadvantaged individual. Outlines specific types of technical assistance and loan guarantees authorized under the Program. Provides loan guarantee limits. Authorizes the Director to enter into agreements for the fulfillment of federal procurement contracts by, and contracting opportunities for, qualified minority businesses. Provides contract limits. Allows the Director to terminate a qualified minority business from the Program under specified circumstances.


SECTION 1. SHORT TITLE. This Act may be cited as the ``Individual Social Security Retirement Account Act of 1993''. SEC. 2. REDUCTION OF SOCIAL SECURITY TAXES. (a) Tax on Employees.--Subsection (a) of section 3101 of the Internal Revenue Code of 1986 (relating to OASDI tax on employees) is amended by striking the table and inserting the following: ``In cases of wages The rate received during: shall be: 1993 or 1994......................... 6.2 percent 1995 or thereafter................... 5.2 percent.'' (b) Tax on Employers.--Subsection (a) of section 3111 of such Code (relating to OASDI tax on employers) is amended by striking the table and inserting the following: ``In cases of wages The rate paid during: shall be: 1993 or 1994......................... 6.2 percent 1995 or thereafter................... 5.2 percent.'' (c) Tax on Self-Employed.--Subsection (a) of section 1401 of such Code of (relating to OASDI tax on self-employment income) is amended by striking the table and inserting the following: ``In the case of a taxable year: Beginning after: And before: Percent: December 31, 1992...... January 1, 1995........ 12.4 December 31, 1994...... ....................... 10.4.'' (d) Effective Date.--The amendments made by this section shall apply with respect to remuneration paid after December 31, 1994, and with respect to earnings from self-employment attributable to taxable years beginning after such date. SEC. 3. INDIVIDUAL SOCIAL SECURITY RETIREMENT ACCOUNTS FUNDED BY SOCIAL SECURITY PAYROLL DEDUCTION PLANS. (a) In General.--Title II of the Social Security Act is amended-- (1) by inserting before section 201 the following: ``Part A--Insurance Benefits''; and (2) by adding at the end the following new part: ``Part B--Individual Retirement Program ``social security payroll deduction plans ``Sec. 251. (a) In General.--Each person who is a covered employer for any calendar year shall have in effect throughout such calendar year a social security payroll deduction plan for such person's eligible employees. ``(b) Requirements.--For purposes of this part, the term `social security payroll deduction plan' means a written plan of a covered employer if-- ``(1) under such plan, the prescribed social security employee contribution is deducted from each eligible employee's wages and paid to an individual social security retirement account of such employee designated in accordance with section 252, ``(2) under such plan, the covered employer pays the amount so deducted to the designated individual social security retirement account within 10 business days after the payment of the wages from which the amount was deducted, ``(3) under such plan, the covered employer pays to the individual social security retirement account, together with the contribution paid pursuant to paragraph (2), the prescribed social security employer contribution with respect to the eligible employee, and ``(4) the employer receives no compensation for the cost of administering such plan. ``(c) Amount Deducted May Be Accumulated by Employer in Certain Cases.--If, under the terms of an individual social security retirement account selected under section 252, contributions below a specified amount will not be accepted, the requirements of subsection (b)(2) shall be treated as met if amounts deducted from the wages of an eligible employee are accumulated by the covered employer and paid to such plan not later than 10 business days after the first day on which the accumulated amount exceeds such specified amount. ``designation of individual social security retirement accounts ``Sec. 252. (a) In General.--Except as provided in subsection (b), the individual social security retirement account to which contributions with respect to any eligible employee are required to be paid under section 251 shall be such an account designated by such employee to such employer not later than 10 business days after the date on which such employee becomes an eligible employee of such employer. Any such designation shall be made in such form and manner as may be prescribed in regulations of the Secretary. ``(b) Designation in Absence of Timely Designation by Employee.--In any case in which no timely designation of the individual social security retirement account is made, the covered employer shall designate such account in accordance with regulations of the Secretary. ``(c) Subsequent Designation of Other Accounts.--The Secretary shall provide by regulation for subsequent designation of other individual social security retirement accounts of an eligible employee in lieu of or in addition to accounts previously designated under this section. ``self-employed individuals ``Sec. 253. (a) In General.--Not later than 30 days after the close of any taxable year for which there is imposed a tax under section 1401(a) of the Internal Revenue Code of 1986 on the self-employment income of an individual, such individual shall pay to an individual social security retirement account designated by such individual the prescribed social security self-employment contribution with respect to such individual for such taxable year. ``(b) Designation of Account.--The designation of an individual social security retirement account for payment of prescribed social security self-employment contributions shall be made in such form and manner as may be prescribed in regulations of the Secretary. ``definitions ``Sec. 254. For purposes of this part-- ``(1) Individual social security retirement account.--The term `individual social security retirement account' means any individual retirement account (as defined in section 408(a) of the Internal Revenue Code of 1986) which is administered or issued by a bank (as defined in section 408(n) of such Code) and which meets the requirements of section 408A of such Code. ``(2) Covered employer.--The term `covered employer' means, for any calendar year, any person on whom an excise tax is imposed under section 3111 of the Internal Revenue Code of 1986 with respect to having an individual in his employ to whom wages were paid by such person during such calendar year. ``(3) Eligible employee.--The term `eligible employee' means, in connection with any person who is a covered employer for any calendar year, any individual with respect to whose employment by such employer during such calendar year there is imposed an excise tax under section 3111 of the Internal Revenue Code of 1986. ``(4) Prescribed social security employee contribution.-- The term `prescribed social security employee contribution' means, with respect to any eligible employee of a covered employer, an amount equal to 1 percent of the wages received by such employee with respect to employment by such employer. ``(5) Prescribed social security employer contribution.-- The term `prescribed social security employer contribution' means, with respect to a covered employer of any eligible employee, 1 percent of the wages paid by such employer to such employee with respect to employment of such employee. ``(6) Prescribed social security self- employment contribution.--The term `prescribed social security self- employment contribution' means, with respect to the self- employment income of an individual for any taxable year, 2 percent of the amount of such self-employment income for such taxable year. ``(7) Business day.--The term `business day' means any day other than a Saturday, Sunday, or legal holiday in the area involved. ``penalties ``Sec. 255. (a) Failure To Establish Social Security Payroll Deduction Plan.--Any covered employer who fails to meet the requirements of section 251 for any calendar year shall be subject to a civil penalty of not to exceed the greater of-- ``(1) $50,000, or ``(2) $1,000 for each eligible employee of such employer as of the beginning of such calendar year. ``(b) Failure To Make Deductions Required Under Plan.--Any covered employer who fails to timely deduct in full the amount from the wages of an eligible employee required under an applicable social security payroll deduction plan shall be subject to a civil penalty of not to exceed $50 for each such failure. ``(c) Failure To Pay Deducted Wages to Individual Social Security Retirement Account.--If an amount deducted from the wages of an eligible employee under a social security payroll deduction plan is not timely paid in full to the designated individual social security retirement account in accordance with section 251-- ``(1) the covered employer failing to make such payment shall be subject to a civil penalty of not to exceed 20 percent of the unpaid amount, and ``(2) shall be liable to the eligible employee for interest on the unpaid amount at a rate equal to 133 percent of the Federal short-term rate under section 1274(d)(1) of the Internal Revenue Code of 1986, calculated from the last day by which such amount was required to be so paid to the date on which such amount is paid into the designated individual social security retirement account. ``(d) Failure To Pay Prescribed Social Security Self-Employment Contributions to Individual Social Security Retirement Account.--Any individual failing to timely pay in full a prescribed social security self-employment contribution to a designated individual social security retirement account as required under section 253 shall be subject to a civil penalty of not to exceed 20 percent of the unpaid amount, plus interest on the unpaid amount at a rate equal to 133 percent of the Federal short-term rate under section 1274(d)(1) of the Internal Revenue Code of 1986, calculated from the last day by which such amount was required to be so paid to the date on which such amount is paid into the designated individual social security retirement account. ``(e) Rules for Application of Section.-- ``(1) Penalties assessed by secretary.--Any civil penalty assessed by this section shall be imposed by the Secretary and collected in a civil action. ``(2) Compromises.--The Secretary may compromise the amount of any civil penalty imposed by this section. ``(3) Authority to waive penalty in certain cases.--The Secretary may waive the application of this section with respect to any failure if the Secretary determines that such failure is due to reasonable cause and not to intentional disregard of rules and regulations.''. (b) Amounts Deducted To Be Shown on W-2 Statements.--Subsection (a) of section 6051 of the Internal Revenue Code of 1986 (relating to receipts for employees) is amended-- (1) by striking ``and'' at the end of paragraph (8), (2) by striking the period at the end of paragraph (9) and inserting ``, and'', and (3) by inserting after paragraph (9) the following new paragraph: ``(10) the total amount deducted from the employee's wages under a social security payroll deduction plan established under part B of title II of the Social Security Act.'' (c) Exemption From ERISA Requirements.--Subsection (b) of section 4 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1003(b)) is amended-- (1) by striking ``or'' at the end of paragraph (4); (2) by striking the period at the end of paragraph (5) and inserting ``; or''; and (3) by adding at the end the following new paragraph: ``(6) such plan is a social security payroll deduction plan established under part B of title II of the Social Security Act.''. (d) Effective Date.-- (1) In general.--The amendments made by subsection (a) shall apply with respect to wages paid in calendar years beginning on or after January 1, 1995. (2) Transitional rule.--Notwithstanding section 252(a) of the Social Security Act (as added by this Act), the initial designations of individual social security retirement accounts with respect to eligible employees employed by covered employers as of January 1, 1995, pursuant to such section may be made at any time not later than January 15, 1995. SEC. 4. TAX TREATMENT OF INDIVIDUAL SOCIAL SECURITY RETIREMENT ACCOUNTS. (a) In General.--Subpart A of part I of subchapter D of chapter 1 of the Internal Revenue Code of 1986 (relating to pension, profit- sharing, stock bonus plans, etc.) is amended by inserting after section 408 the following new section: ``SEC. 408A. INDIVIDUAL SOCIAL SECURITY RETIREMENT ACCOUNTS. ``(a) General Rule.--Except as provided in this section, an individual social security retirement account shall be treated for purposes of this title in the same manner as an individual retirement plan. ``(b) Individual Social Security Retirement Account.--For purposes of this section, the term `individual social security retirement account' means an account established and administered in accordance with part B of title II of the Social Security Act (relating to individual retirement program). ``(c) Contribution Rules.-- ``(1) No deduction allowed.--No deduction shall be allowed under section 219 for a contribution to an individual social security retirement account. ``(2) Contribution limit.--No amount, other than a prescribed contribution under part B of title II of the Social Security Act, may be accepted as a contribution to an individual social security retirement account. ``(d) Treatment of Rollovers.--Section 408(d)(3)(A)(i) shall apply to any amount distributed from an individual social security retirement account only to the extent such amount is paid into another such account for the benefit of the individual for whom the account from which such amount is transferred was maintained.'' (b) Clerical Amendment.--The table of sections for such subpart A is amended by inserting after the item relating to section 408 the following new item: ``Sec. 408A. Individual social security retirement accounts.'' (c) Effective Date.--The amendments made by this section shall apply to taxable years beginning after December 31, 1994.

Summary: Individual Social Security Retirement Account Act of 1993 - Amends the Internal Revenue Code to reduce the social security taxes on employees, employers, and the self-employed for 1995 and thereafter. Amends title II (Old-Age, Survivors and Disability Insurance) of the Social Security Act to require employers to have in effect a social security payroll deduction plan for employees. Requires such plan to provide for employers to deduct the prescribed social security employee contribution for transfer, together with the prescribed social security employer contribution, to an individual social security retirement account of the employee. Provides for self-employed individuals to pay into such accounts the prescribed social security self-employment contribution. Sets forth penalties for failure to establish and maintain such accounts. Requires amounts deducted from employee wages to be shown on wage receipts for employees. Amends the Employee Retirement Income Security Act of 1974 to exempt social security payroll deduction plans from provisions governing employee benefit plans. Provides for the tax treatment of individual social security retirement accounts in a manner similar to individual retirement accounts.


SECTION 1. INCENTIVES FOR INNOVATIVE TECHNOLOGIES LOAN GUARANTEE PROGRAM. (a) Specific Appropriation or Contribution.--Section 1702 of the Energy Policy Act of 2005 (42 U.S.C. 16512) is amended-- (1) by striking subsection (b) and inserting the following: ``(b) Specific Appropriation or Contribution.-- ``(1) In general.--No guarantee shall be made unless-- ``(A) an appropriation for the cost of the guarantee has been made; ``(B) the Secretary has received from the borrower a payment in full for the cost of the guarantee and deposited the payment into the Treasury; or ``(C) a combination of appropriations under subparagraph (A) or payments from the borrower under subparagraph (B) has been made that is sufficient to cover the cost of the guarantee. ``(2) Limitation.--The source of payments received from a borrower under subparagraph (B) or (C) of paragraph (1) shall not be a loan or other debt obligation that is made or guaranteed by the Federal Government.''; and (2) by adding at the end the following: ``(l) Credit Report.--If, in the opinion of the Secretary, a third- party credit rating of the applicant or project is not relevant to the determination of the credit risk of a project, if the project costs are not projected to exceed $100,000,000, and the applicant agrees to accept the credit rating assigned to the applicant by the Secretary, the Secretary may waive any otherwise applicable requirement (including any requirement described in part 609 of title 10, Code of Federal Regulations) to provide a third-party credit report. ``(m) Direct Hire Authority.-- ``(1) In general.--Notwithstanding sections 3304 and sections 3309 through 3318 of title 5, United States Code, the head of the loan guarantee program under this title (referred to in this subsection as the `Executive Director') may, on a determination that there is a severe shortage of candidates or a severe hiring need for particular positions to carry out the functions of this title, recruit and directly appoint highly qualified critical personnel with specialized knowledge important to the function of the programs under this title into the competitive service. ``(2) Exception.--The authority granted under paragraph (1) shall not apply to positions in the excepted service or the Senior Executive Service. ``(3) Requirements.--In exercising the authority granted under paragraph (1), the Executive Director shall ensure that any action taken by the Executive Director-- ``(A) is consistent with the merit principles of section 2301 of title 5, United States Code; and ``(B) complies with the public notice requirements of section 3327 of title 5, United States Code. ``(4) Sunset.--The authority provided under paragraph (1) shall terminate on September 30, 2011. ``(n) Professional Advisors.--The Secretary may-- ``(1) retain agents and legal and other professional advisors in connection with guarantees and related activities authorized under this title; ``(2) require applicants for and recipients of loan guarantees to pay all fees and expenses of the agents and advisors; and ``(3) notwithstanding any other provision of law, select such advisors in such manner and using such procedures as the Secretary determines to be appropriate to protect the interests of the United States and achieve the purposes of this title. ``(o) Multiple Sites.--Notwithstanding any contrary requirement (including any provision under part 609.12 of title 10, Code of Federal Regulations) an eligible project may be located on 2 or more non- contiguous sites in the United States.''. (b) Applications for Multiple Eligible Projects.--Section 1705 of the Energy Policy Act of 2005 (42 U.S.C. 16516) is amended-- (1) by redesignating subsection (e) as subsection (f); and (2) by inserting after subsection (d) the following: ``(e) Multiple Applications.--Notwithstanding any contrary requirement (including any provision under part 609.3(a) of title 10, Code of Federal Regulations), a project applicant or sponsor of an eligible project may submit an application for more than 1 eligible project under this section.''. (c) Energy Efficiency Loan Guarantees.--Section 1705(a) of the Energy Policy Act of 2005 (42 U.S.C. 16516(a)) is amended by adding at the end the following: ``(4) Energy efficiency projects, including projects to retrofit residential, commercial, and industrial buildings, facilities, and equipment.''. (d) Fees; Professional Advisors.--Section 136 of the Energy Independence and Security Act of 2007 (42 U.S.C. 17013) is amended-- (1) by striking subsection (f) and inserting the following: ``(f) Fees.--Except as otherwise permitted under subsection (i), administrative costs shall be not more than $100,000 or 10 basis points of the loan.''; (2) by redesignating subsections (i) and (j) as subsections (j) and (k), respectively; and (3) by inserting after subsection (h) the end the following: ``(i) Professional Advisors.--The Secretary may-- ``(1) retain agents and legal and other professional advisors in connection with guarantees and related activities authorized under this section; ``(2) require applicants for and recipients of loan guarantees to pay directly, or through the payment of fees to the Secretary, all fees and expenses of the agents and advisors; and ``(3) notwithstanding any other provision of law, select such advisors in such manner and using such procedures as the Secretary determines to be appropriate to protect the interests of the United States and achieve the purposes of this section.''.

Summary: Amends the Energy Policy Act of 2005 (EPA) to prohibit federal loan guarantees for innovative technologies unless: (1) an appropriation for the cost of the guarantee has been made; (2) the Secretary of Energy (DOE) has received and deposited into the Treasury payment in full from the borrower for the cost of the guarantee; or (3) a combination of appropriations or payments from the borrower has been made that is sufficient to cover the cost of the guarantee. Authorizes the Secretary to waive requirements to provide a third-party credit report if: (1) such report, in the Secretary's opinion, is not relevant to the determination of the credit risk of a project; (2) the project costs are not projected to exceed $100 million; and (3) the applicant agrees to accept the credit rating the Secretary assigns. Authorizes the head of the loan guarantee program, if there is either a severe shortage of candidates or a severe hiring need for particular positions, to recruit and directly appoint into the competitive service highly qualified critical personnel with specialized knowledge important to program functions (direct hire authority). Amends the EPA and the Energy Independence and Security Act of 2007 to authorize the Secretary to: (1) retain agents and professional advisors in connection with guarantees and related activities; and (2) require loan guarantee applicants and recipients to pay all fees and expenses of such agents and advisors. Authorizes the Secretary to make energy efficiency loan guarantees for projects starting construction by September 30, 2011, to retrofit residential, commercial, and industrial buildings, facilities, and equipment.


SECTION 1. SHORT TITLE. This Act may be cited as the ``Brownfield Redevelopment and Economic Development Innovative Financing Act of 2014''. SEC. 2. BROWNFIELD REDEVELOPMENT AND ECONOMIC DEVELOPMENT INNOVATIVE FINANCING PROGRAM. (a) Establishment and Purpose.--The Secretary of Housing and Urban Development, in consultation with the Secretary of the Treasury, shall establish a program, to be known as the Brownfield Redevelopment and Economic Development Innovative Financing program, under which the Secretary may guarantee, and make commitments to guarantee, the repayment of principal and interest on loans made by lenders to local governments, local redevelopment agencies, or BRAC redevelopment projects for the purposes of carrying out projects for redeveloping brownfields and promoting urban renewal. (b) Eligibility Requirements.-- (1) Application.--A local government, local redevelopment agency, or BRAC redevelopment project shall be eligible to receive a loan guarantee under the Program only if such government, agency, or project submits to the Secretary (at such time and in such form as the Secretary may require)-- (A) a master plan that meets the requirements under subsection (c); (B) a certification from the Environmental Protection Agency, or an entity designated by the Environmental Protection Agency, that the brownfield to be redeveloped under the master plan requires environmental remediation; and (C) any other information as the Secretary may require. (2) Loan eligibility.--A loan may be guaranteed under the Program only if the loan meets the following requirements: (A) Use.--Such loan shall be used for costs of carrying out a project to redevelop brownfields and promote urban renewal, which may include-- (i) acquisition of a brownfield site; (ii) remediation of a brownfield site; (iii) relocation of existing facilities in operation on the redevelopment site; or (iv) site preparation, including the installation of utilities, sewers, storm drains, and transportation facilities. (B) Contamination.--A local government, local redevelopment agency, or BRAC redevelopment project may not receive a loan guarantee under the Program if the applying agency was responsible for contaminating a brownfield to be redeveloped using such loan. (C) Number of loans.--A local government, local redevelopment agency, or BRAC redevelopment project may not at any time have more than one outstanding loan that is guaranteed under the Program. (D) Amount of principal.--The original principal amount of such loan shall not-- (i) be less than $25,000,000; and (ii) exceed the lesser of-- (I) the total cost of the redevelopment project for which the loan is to be used; or (II) $150,000,000. (E) Interest rate.--Such loan shall bear interest at a rate negotiated between the lender and the borrower, subject to any limitations that the Secretary may establish. (F) Duration.--The term to maturity of such loan shall not be shorter than 20 years nor longer than 30 years. (G) Repayment.--Such loan-- (i) shall not require any repayment of principal or interest within 10 years after the date that the lender makes the loan to the borrower; and (ii) shall require that repayment shall begin not later than 15 years after the date that such loan is made. (c) Master Plan.--A master plan under this subsection shall describe the proposed brownfield redevelopment project for which the loan guarantee is to be made, and shall include-- (1) a description of the project to be funded by the loan, including a schedule of activities to be undertaken and a budget for such project; (2) a demonstration that the brownfield redevelopment project will result in major redevelopment, based on economic development and environmental quality and restoration, in the community in which such project is located, which shall include information regarding-- (A) the extent of non-Federal funds committed to the project; (B) the number of long-term jobs created by the project; (C) the environmental remediation of brownfield sites due to the project; (D) a description of the environmental and economic impact of the project on the community; (E) the amount of affordable housing created by the project; (F) the reduction of vehicle congestion and emissions expected to result from the project; (G) the extent of integration of green technology into developments and buildings created by the project; (H) the extent of improvement in air quality expected to result from the project; and (I) the extent to which complete streets planning and transit-oriented development is incorporated into the project; (3) evidence of the commitments of investment from non- Federal entities, established through zoning or other documentation; and (4) a remediation action plan that has been approved by the Environmental Protection Agency, or its designee. (d) Selection Criteria.--The Secretary shall establish criteria for selecting local governments, local redevelopment agencies, and BRAC redevelopment projects to receive loan guarantees under the Program. Such criteria shall take into consideration the information required under subsection (c)(2). Such criteria shall provide that existing BRAC redevelopment projects having existing Federal grants, loans, or other assistance or commitments for Federal grants, loans, or other assistance, shall be given additional favorable consideration toward such selection. (e) Full Faith and Credit.--The full faith and credit of the United States is pledged to the payment of all guarantees made under this section. Any such guarantee made by the Secretary shall be conclusive evidence of the eligibility of the obligations for such guarantee with respect to principal and interest, and the validity of any such guarantee so made shall be incontestable in the hands of a holder of the guaranteed obligations. (f) Protection Against Liability for Environmental Remediation.-- The Federal Government shall not be liable under the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (42 U.S.C. 9601 et seq.) or any other Federal, State, or local law as a result of a loan guarantee made under this section. (g) Processing; Repayment and Collateral; Congressional Oversight.-- (1) Processing.--The Secretary shall consider, process, and approve all requests for loan guarantees under this section using an approval process that is substantially identical to the approval process used for loan guarantees provided under section 108 of the Housing and Community Development Act of 1974 (42 U.S.C. 5308). (2) Repayment schedule and collateralization.--To be eligible for a loan guarantee under this section, an applicant shall demonstrate a viable repayment schedule and shall provide sufficient collateral to ensure repayment of loans so guaranteed, which may be in the form of a pledge of grants for which the applicant may become eligible under title I of the Housing and Community Development Act of 1974 (42 U.S.C. 5301 et seq.), except that the Secretary may not require a pledge of such grants as collateral and shall provide for applicants to provide collateral in other forms, at the option of the applicant. (3) Congressional oversight.--Before final approval of any loan guarantee under this section, the Secretary shall notify the Committees on Financial Services and Appropriations of the House of Representatives and Committees on Banking, Housing, and Urban Affairs and Appropriations of the Senate of such approval. (h) Definitions.--For purposes of this section the following definitions shall apply: (1) BRAC redevelopment project.--The term ``BRAC redevelopment project'' means a project to redevelop a site that has been designated as a Base Realignment and Closure Site by the Secretary of Defense, through the Defense Base Closure and Realignment Commission, and is listed on the website of the Department of Defense as such a site. (2) Brownfield.--The term ``brownfield'' has the meaning given such term in section 101(39) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (42 U.S.C. 9601(39). (3) Local redevelopment agency.--The term ``local redevelopment agency'' means any agency, office, or division of a State government whose purpose includes improving blighted, deteriorated, or otherwise economically depressed areas. (4) Remediation action plan.--The term ``remediation action plan'' means, with respect to a brownfield redevelopment project, a document that describes how the project site will be remediated, what technology will be used to accomplish such remediation, and when the remediation actions will take place. (5) Program.--The term ``Program'' means the Brownfield Redevelopment and Economic Development Innovative Financing program established under this section. (6) Secretary.--The term ``Secretary'' means the Secretary of Housing and Urban Development. (i) Regulations.--Not later than 6 months after the date of enactment of this section, the Secretary shall issue regulations as may be necessary to carry out the Program. (j) Authorization of Appropriations.--There is authorized to be appropriated to the Secretary $100,000,000 for fiscal year 2015 for costs (as such term is defined in section 502 of the Federal Credit Reform Act of 1990 (2 U.S.C. 661a)) of loans guaranteed under this section, which amounts shall remain available through fiscal year 2019.

Summary: Brownfield Redevelopment and Economic Development Innovative Financing Act of 2014 - Directs the Secretary of Housing and Urban Development (HUD) to establish the Brownfield Redevelopment and Economic Development Innovative Financing Program, under which the Secretary may guarantee the repayment of loans made by lenders to local governments, local redevelopment agencies, or Base Realignment and Closure Commission (BRAC) redevelopment projects to carry out projects for redeveloping brownfields and promoting urban renewal. Requires such an entity, in order to receive such a loan guarantee, to submit: (1) a master plan that describes the proposed brownfield redevelopment project, demonstrates that such project will result in major redevelopment, provides evidence of investment commitments from non-federal entities, and includes a remediation action plan approved by the Environmental Protection Agency (EPA); and (2) a certification from EPA that the brownfield to be redeveloped requires environmental remediation. Prohibits an entity from: (1) receiving a loan guarantee if it was responsible for contaminating the brownfield to be redeveloped, or (2) having more than one outstanding loan that is guaranteed under the Program. Sets forth requirements regarding an eligible loan's principal amount, interest rate, duration, and repayment terms. Directs the Secretary to establish criteria for selecting entities to receive loan guarantees.


SECTION 1. SHORT TITLE. This Act may be cited as the ``Medicare Fraud Enforcement and Prevention Act of 2010''. SEC. 2. ENHANCED CRIMINAL PENALTIES TO COMBAT MEDICARE AND MEDICAID FRAUD. (a) In General.--Section 1128B of the Social Security Act (42 U.S.C. 1320a-7b) is amended-- (1) in subsection (a), by striking ``$10,000 or imprisoned for not more than one year'' and inserting ``$20,000 or imprisoned for not more than two years''; and (2) in each of subsections (a), (b)(1), (b)(2), (c), and (d), by striking ``$25,000 or imprisoned for not more than five years'' and inserting ``$50,000 or imprisoned for not more than 10 years''. (b) Illegal Distribution of Medicare or Medicaid Beneficiary Identification or Billing Privileges.--Section 1128B of such Act (42 U.S.C. 1320a-7b) is amended by adding at the end the following new subsection: ``(g) Whoever knowingly, intentionally, and with the intent to defraud purchases, sells, or distributes, or arranges for the purchase, sale, or distribution of two or more Medicare or Medicaid beneficiary identification numbers or billing privileges under title XVIII or title XIX shall be imprisoned for not more than three years or fined under title 18, United States Code (or, if greater, an amount equal to the monetary loss to the Federal and any State government as a result of such acts), or both.''. (c) Effective Date.--The amendments made by this section shall apply to acts committed on or after the date of the enactment of this Act. SEC. 3. ENHANCED CIVIL AUTHORITIES TO COMBAT MEDICARE AND MEDICAID FRAUD. (a) Civil Monetary Penalties Law Alignment and Other Changes.-- (1) Section 1128A(a) of the Social Security Act (42 U.S.C. 1320a-7a(a)) is amended-- (A) in paragraph (1), by striking ``to an officer, employee, or agent of the United States, or of any department or agency thereof, or of any State agency (as defined in subsection (i)(1)),''; (B) by inserting after paragraph (10), as added by section 6402(d)(2) of the Patient Protection and Affordable Care Act (Public Law 111-148) the following new paragraphs: ``(11) conspires to commit a violation of this section; or ``(12) knowingly makes, uses, or causes to be made or used, a false record or statement material to an obligation to pay or transmit money or property to a Federal health care program, or knowingly conceals or knowingly and improperly avoids or decreases an obligation to pay or transmit money or property to a Federal health care program;''; (C) in the first sentence-- (i) by striking ``or in cases under paragraph (9)'' and inserting ``in cases under paragraph (9)''; and (ii) by striking ``fact)'' and inserting ``fact), in cases under paragraph (11), $50,000 for any violation described in this section committed in furtherance of the conspiracy involved, and in cases under paragraph (12), $50,000 for each false record or statement, or concealment, avoidance, or decrease''; and (D) in the second sentence, by striking ``material fact).'' and inserting ``material fact); or in cases under paragraph (11), an assessment of not more than 3 times the total amount that would otherwise apply for any violation described in this section committed in furtherance of the conspiracy involved; or in cases under paragraph (12), an assessment of not more than 3 times the total amount of the obligation to which the false record or statement was material or that was avoided or decreased.''. (2) Section 1128A(c)(1) of the Social Security Act (42 U.S.C. 1320a-7a(c)(1)) is amended by striking ``six years'' and inserting ``10 years''. (3) Section 1128A(i) of the Social Security Act (42 U.S.C. 1320a-7a(i)) is amended-- (A) by amending paragraph (2) to read as follows: ``(2) The term `claim' means any application, request, or demand, whether under contract, or otherwise, for money or property for items and services under a Federal health care program (as defined in section 1128B(f)), whether or not the United States or a State agency has title to the money or property, that-- ``(A) is presented or caused to be presented to an officer, employee, or agent of the United States, or of any department or agency thereof, or of any State agency (as defined in subsection (i)(1)); or ``(B) is made to a contractor, grantee, or other recipient if the money or property is to be spent or used on the Federal health care program's behalf or to advance a Federal health care program interest, and if the Federal health care program-- ``(i) provides or has provided any portion of the money or property requested or demanded; or ``(ii) will reimburse such contractor, grantee, or other recipient for any portion of the money or property which is requested or demanded.''; (B) by amending paragraph (3) to read as follows: ``(3) The term `item or service' means, without limitation, any medical, social, management, administrative, or other item or service used in connection with or directly or indirectly related to a Federal health care program.''; (C) in paragraph (7)-- (i) by striking ``term `should know' means'' and inserting ``terms `knowing', `knowingly', and `should know' mean''; (ii) by redesignating subparagraphs (A) and (B) as subparagraphs (B) and (C), respectively; (iii) by inserting before subparagraph (B), as redesignated by clause (ii), the following new subparagraph: ``(A) has actual knowledge of the information;''; and (iv) in the matter following subparagraph (C), as redesignated by clause (ii)-- (I) by inserting ``require'' after ``and''; and (II) by striking ``is required''; and (D) by adding at the end the following new paragraphs: ``(8) The term `obligation' means an established duty, whether or not fixed, arising from an express or implied contractual, grantor-grantee, or licensor licensee relationship, from a fee-based or similar relationship, from statute or regulation, or from the retention of any overpayment. ``(9) The term `material' means having a natural tendency to influence, or be capable of influencing, the payment or receipt of money or property.''. (b) Exclusion of Responsible Corporate Officials.--Section 1128(b) of the Social Security Act (42 U.S.C. 1320a-7(b)) is amended by striking clauses (i) and (ii) of paragraph (15)(A) and inserting the following: ``(i) who has or had a direct or indirect ownership or control interest in a sanctioned entity at the time of and who knew or should have known (as defined in section 1128(i)(7)) of any of the conduct that formed a basis for the conviction or exclusion described in subparagraph (B); or ``(ii) who is or was an officer or managing employee (as defined in section 1126(b)) of such an entity at the time of any of the conduct that formed a basis for the conviction or exclusion so described.''. (c) Payment Suspensions.--Subsection (o)(1) of section 1862 of the Social Security Act (42 U.S.C. 42 U.S.C. 1395y), as added by section 6402(h) of the Patient Protection and Affordable Care Act (Public Law 111-148), is amended by striking ``may'' and inserting ``shall''. (d) Civil Monetary Penalties for False Statements or Delaying Inspections.--Paragraph (9) of section 1128A(a) of the Social Security Act (42 U.S.C. 1320a-7a(a)), as added by section 6408(a) of the Patient Protection and Affordable Care Act (Public Law 111-148), is amended by inserting ``or to timely provide information in response to a request authorized by section 1128J(b),'' after ``regulations),''. SEC. 4. ENHANCED SCREENING, MEDICARE DATA-MINING SYSTEM; BIOMETRIC TECHNOLOGY PILOT PROGRAM. (a) Enhanced Screening.--Section 1866(j)(2)(B)(ii) of the Social Security Act (42 U.S.C. 1395cc(j)), as inserted by section 6401(a)(3) of the Patient Protection and Affordable Care Act (Public Law 111-148), is amended by striking ``may'' and inserting ``shall''. (b) Access to Real Time Claims and Payment Data.-- Section1128J(a)(2) of the Social Security Act, as added by section 6402(a) of the Patient Protection and Affordable Care Act (Public Law 111-148), is amended-- (1) by inserting ``including real time claims and payment data,'' after ``access to claims and payment data''; and (2) by adding at the end the following sentence: ``In carrying out this section, the Inspector General of the Department of Health and Human Services, in consultation with the Attorney General, shall implement mechanisms for the sharing of information about suspected fraud relating to the Federal health care programs under titles XVIII, XIX, and XXI with other appropriate law enforcement officials.''. (c) Biometric Technology Pilot Program.-- (1) In general.--By not later than one year after the date of the enactment of this Act, the Secretary of Health and Human Services shall carry out a 5-year pilot program that implements biometric technology to ensure that individuals entitled to benefits under part A of title XVIII of the Social Security Act or enrolled under part B of such title are physically present at the time and place of receipt of certain items and services (specified by the Secretary) for which payment may be made under such title. Under such pilot program the Secretary may provide for financial incentives to encourage voluntary participation of providers of services (as defined in section 1861(u) of such Act) and suppliers (as defined in section 1861(d) of such Act). (2) Reports.--The Secretary of Health and Human Services shall, for each of the third, fourth, and fifth years of the pilot program under paragraph (1), submit to Congress a report on the effectiveness of the pilot program in reducing the occurrence of waste, fraud, and abuse in the Medicare program under title XVIII of the Social Security Act. (3) Authorization of appropriations.--For purpose of carrying out paragraph (1), there is authorized to be appropriated such sums as may be necessary. SEC. 5. GAO STUDY AND REPORT. (a) Study.--The Comptroller General of the United States shall conduct a study on Medicare administrative contractors under section 1874A of the Social Security Act, including Recovery Audit Contractors, regarding the following areas: (1) Training and expertise in identifying fraud, including the education levels of the key individuals tasked to identify or refer potential cases of fraud, and whether the Centers for Medicare & Medicaid Services should be providing more training to contractors, or require contractors to hire experts with greater medical training. (2) Acquisition and implementation of data mining software among Medicare administrative contractors, if applicable, and the ability or availability of such software to provide real- time data mining capabilities. (b) Report.--Not later than one year after the date of the enactment of this Act, the Comptroller General of the United States shall complete the study under this section and submit a report to Congress regarding the findings of the study and recommendations for legislation and administrative action.

Summary: Medicare Fraud Enforcement and Prevention Act of 2010 - Amends title XI of the Social Security Act (SSA) to increase criminal penalties for both felony and misdemeanor fraud under SSA titles XVIII (Medicare) and XIX (Medicaid). Adds a new offense of distribution of two or more Medicare or Medicaid beneficiary identification numbers or billing privileges with the intent to defraud. Applies civil monetary penalties to: (1) conspiracy to make false statements or commit other specified offenses with respect to Medicare or Medicaid claims; and (2) knowing creation or use of false records or statements with respect to the transmission of money or property to a federal health care program. Extends the statute of limitations from six to 10 years after presentation of a claim. Amends SSA title XVIII (Medicare), as amended by the Patient Protection and Affordable Care Act (PPACA), to revise screening requirements. Amends SSA title XI, as amended by PPACA, to require the access to claims and payment data granted to Inspector General of the Department of Health and Human Services (HHS) and the Attorney General to include access to real time claims and payment data. Requires the HHS Inspector General to implement mechanisms for the sharing of information about suspected fraud relating to the federal health care programs under Medicare, Medicaid, and SSA title XXI (Children's Health Insurance Program) (CHIP) with other appropriate law enforcement officials. Directs the HHS Secretary to carry out a five-year pilot program that implements biometric technology to ensure that individuals entitled to benefits under Medicare part A or enrolled under Medicare part B are physically present at the time and place of receipt of certain items and services for which payment may be made. Requires the Comptroller General to study and report to Congress on Medicare administrative contractors, including Recovery Audit Contractors.