Omnibus Budget Reconciliation Act of 1993

TABLE OF CONTENTS: Title I: Agriculture and Related Provisions Title II: Armed Services Provisions Title III: Banking and Housing Provisions Title IV: Student Loans and ERISA Provisions Title V: Transportation and Public Works Provisions Title VI: Communications Licensing and Spectrum Allocation Provisions Title VII: Nuclear Regulatory Commission Provisions Title VIII: Patent and Trademark Office Provisions Title IX: Merchant Marine Provisions Title X: Natural Resources Provisions Title XI: Civil Service and Post Office Provisions Title XII: Veterans' Affairs Provisions Title XIII: Revenue, Health Care, Human Resources, Income Security, Customs and Trade Provisions, Food Stamp Program, and Timber Sale Provisions Title XIV: Budget Process Provisions Omnibus Budget Reconciliation Act of 1993 - Title I: Agricultural Programs - Agricultural Reconciliation Act of 1993 - Subtitle A: Commodity Programs - Amends the Agricultural Act of 1949 to extend specified upland cotton loan, payment, acreage reduction, and marketing loan programs. (Sec. 1101) Extends and reduces, with specified exceptions, acreage eligible for deficiency payments from 92 percent to 85 percent for upland cotton, wheat, feed grains, and rice. (Sec. 1105) Extends the dairy support program. Sets forth purchase price ceilings for butter and nonfat dry milk. Reduces milk prices by ten cents per hundredweight for 1996. Prohibits the sale of bovine growth hormone during a specified time period. (Sec. 1106) Amends the Agricultural Adjustment Act of 1938 to require domestic cigarette manufacturers to certify that their products contain at least 75 percent U.S.-grown tobacco. Requires domestic manufacturers who do not meet such requirements to: (1) pay specified marketing assessments; and (2) purchase specified quantities of Burley and Flue-cured tobacco. Authorizes the Secretary of Agriculture to reduce U.S. content requirements in cases of disaster-related crop losses. Amends the Agricultural Act of 1949 to require importers of foreign tobacco to pay: (1) specified marketing assessments; and (2) specified assessments to the No Net Cost Tobacco Fund. Amends the Tobacco Adjustment Act of 1983 to subject imported tobacco to inspection fees on the same basis as domestic tobacco. Amends the Agricultural Adjustment Act of 1938 to extend quota reduction floor authority (with waiver authority to avoid excess inventories) for burley and Flue-cured tobacco. (Sec. 1107) Amends the Agricultural Act of 1949 to extend the sugar price support program. (Sec. 1108) Extends and reduces from current levels the oilseeds loan program. Revises loan maturation provisions. Eliminates loan organization fees for post-1993 crop years. (Sec. 1109) Extends specified provisions of the peanut price support program. Extends and increases marketing assessment rates. Revises first purchaser-producer assessment provisions. (Sec. 1110) Extends and reduces from current levels: (1) the honey price support program; and (2) individual payment ceilings. Eliminates post-1994 honey marketing assessment authority. (Sec. 1111) Amends the National Wool Act of 1954 to extend and reduce from current levels: (1) the wool and mohair price support program; and (2) individual payment ceilings. Prohibits the deduction of certain marketing charges in determining net sales proceeds and national payment rates. Subtitle B: Rural Electrification - Amends the Rural Electrification Act of 1936 to authorize refinancing and prepayment of Federal Financing Bank loans guaranteed by the Rural Electrification Administration. Sets forth penalty and loan term provisions. Subtitle C: Agricultural Trade - Amends the Omnibus Budget Reconciliation Act of 1990 to eliminate: (1) certain acreage reduction requirements for grain sorghum and barley; and (2) specified authority of the Secretary to waive certain acreage reduction requirements with regard to the General Agreement on Tariffs and Trade (GATT) (Sec. 1302) Amends the Agricultural Trade Act of 1978 to extend and reduce from current levels the authorization of appropriations for the marketing promotion program. Revises such program to: (1) permit assistance, with exceptions, only to counter unfair trade practices; (2) give priority to small entities; (3) limit the assistance period; (4) require trade organization contributions; and (5) prohibit assistance for tobacco marketing. Subtitle D: Miscellaneous - Authorizes the Secretary to charge admission, entrance, and recreation fees at appropriate sites and public or recreation areas. Amends the Food Security Act of 1985 with regard to the conservation reserve program to: (1) make the current discretionary enrollment provision mandatory; (2) reduce acreage requirements; and (3) eliminate the 1994 acreage requirement. Extends the wetlands reserve program and revises acreage enrollment provisions. (Sec. 1403) Amends the Federal Crop Insurance Act to direct the Federal Crop Insurance Corporation to take specified actions to improve the actuarial soundness of Federal crop insurance coverage. Title II: Armed Services Provisions - Specifies, with respect to increases in the retired pay of former military personnel who became a member of the armed forces before August 1, 1986, the initial month for which increases becoming effective on December 1 of FY 1994 through 1998 shall be payable. Makes such provisions inapplicable to those former personnel who were retired or separated due to disability. Title III: Banking and Housing Provisions - Amends the Federal Deposit Insurance Act to prescribe an order of priority for the distribution of amounts realized from the resolution of any insured depository institution in receivership. Requires that any distribution in connection with certain claims be accompanied by a specified accounting report. (Sec. 3002) Amends the Federal Reserve Act to mandate that for FY 1997 and FY 1998 specified percentages of the surplus fund of any Federal reserve bank be transferred into the Treasury. Prohibits a Federal reserve bank from replenishing its surplus fund by the amount of such transfer. (Sec. 3003) Amends the Stewart B. McKinney Homeless Assistance Amendments Act of 1988 to: (1) include Indian housing programs within certain Department of Housing and Urban Development programs; (2) require that certain income disclosure consent forms be submitted in order to verify applicant eligibility for benefits; and (3) amend applicant, participant, and public housing agency protections. (Sec. 3004) Amends the National Housing Act to direct the Government National Mortgage Association (GNMA) to: (1) charge fees in connection with its multiclass securities guarantee program (the program); and (2) take steps to assure that a certain portion of the benefit resulting from the program acrues to mortgagors who execute eligible mortgages. (Sec. 3005) Directs the Secretary of Housing and Urban Development to increase the rate at which the Secretary earns the single premium payment collected at the time of insurance of a mortgage that is an obligation of the Mutual Mortgage Insurance Fund. Title IV: Student Loan ERISA Provisions - Subtitle A: Direct Student Loan Provisions - Student Loan Reform Act of 1993 - Amends the Higher Education Act of 1965 (HEA) to replace the Federal Family Education Loan Program, under which loans made by private lenders are guaranteed by the Government with a Federal Direct Student Loan Program, to be partially phased in over a five-year transition period. Chapter 1: Federal Direct Student Loan Program - Amends HEA to change the Federal Direct Loan Demonstration Program to the Federal Direct Student Loan Program (FDSL). (Sec. 4021) Sets forth program authority for making necessary sums available to make FDSL loans to all eligible students (and parents) at participating higher education institutions selected by the Secretary of Education (Secretary), for the period beginning July 1, 1994. Requires such loans to be made by participating institutions that also have agreements with the Secretary to originate loans, or by alternative originators designated by the Secretary. Directs the Secretary to provide funds for such student and parent loans either directly to a participating institution that also has an origination agreement or to a designated alternative originator, on the basis of need and eligibility of students and parents at each participating institution. Requires the Secretary to pay fees to assist in meeting costs of loan origination to participating institutions or alternative originators. Declares that no institution shall have a right to participate in FDSL programs. Provides for phase-in of the program. Authorizes the Secretary to exceed the percentage goals for 1996-7 through 1998-9 upon determination that a higher percentage is warranted by the number of eligible institutions desiring to participate. Sets forth selection criteria for an institution's participation in the FDSL program and in origination agreements. Allows consortia of eligible participating institutions to apply to originate FDSL loans. Sets forth transition selection criteria. Sets forth FDSL program participation and origination agreement requirements for institutions. Sets forth terms and conditions for FDSL loans, including certain parallels with Stafford, supplemental, parent, and unsubsidized Stafford loans under the FFEL program. Sets lower interest rates for Federal Direct Stafford Loans and Federal Direct Unsubsidized Stafford Loans made on or after July 1, 1994. Sets lower loan fees to be charged to borrowers. Provides for standard, extended, graduated, and income contingent repayment plan options. Sets forth deferment possibilities. Sets forth provisions for consolidation, borrower defenses, loan application and promissory note, loan disbursement, and fiscal control and fund accountability. Authorizes the Secretary to award contracts under the FDSL program for: (1) alternative origination of loans; (2) servicing and collection of loans; (3) data systems for records maintenance; and (4) services to assist in orderly transition from FFEL to FDSL programs. Provides funds for specified administrative expenses of the FDSL program and of the transition from the FFEL program, including certain transition expenses of guaranty agencies. Requires budget justification and notification to specified congressional committees by the Secretary. Chapter 2: Conforming Amendments to the Higher Education Act of 1965 - Amends HEA with respect to access to FFEL program student and parent loans during the transition to the FDSL program. (Sec. 4041) Provides for advances to guaranty agencies for lender-of-last resort services. Requires the Student Loan Marketing Association (Sallie Mae) or its designated agent to begin making FFEL loans as lender-of-last-resort, subject to certain limitations, upon the Secretary's request, and to cease such lending when the triggering conditions have ceased. (Sec. 4047) Provides for consolidation of programs by setting annual and aggregate loan limits for independent, graduate, and professional students. Subtitle B: Additional Savings from the Student Loan Programs - Reduces interest rates for new student loans. (Sec. 4102) Reduces student loan origination fees which are paid by students. (Sec. 4103) Requires lenders to pay fees. (Sec. 4104) Requires the Student Loan Marketing Association to pay an offset fee to the Secretary. (Sec. 4105) Reduces the amount of the tax exemption granted to holders of certain student loans. (Sec. 4106) Reduces the interest rate for consolidation loans. Requires holders of consolidation loans to pay a rebate fee to the Secretary. (Sec. 4107) Reduces certain maximum interest premiums. Eliminates certain reinsurance fees. (Sec. 4108) Lowers the percentage for guaranty agency reinsurance and makes risk sharing more for loans held. (Sec. 4109) Requires multiple disbursement of parent (PLUS) loans. (Sec. 4110) Revises provisions for the Secretary's equitable share and for supplemental preclaims assistance. (Sec. 4111) Reduces the special allowance payment. (Subtitle C: Cost Sharing by States - Amends HEA to requires any State in which there are higher education institutions with cohort default rates exceeding 20 percent to pay the Secretary specified portions of costs related to such loan defaults. Allows States to charge institutions fees based on their cohort default rate and the State's risk of loss. Subtitle D: Group Health Plans - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to establish additional standards for group health plans. (Sec. 4301) Requires group health plan coverage pursuant to medical child support orders. Provides for rights of States with respect to group health plans where participants or beneficiaries are eligible for Medicaid benefits. Requires group health plan coverage of dependent children in cases of adoption. Prohibits a group health plan from reducing its coverage of the pediatric vaccines below that provided as of May 1, 1993. Requires group health plans to provide information necessary to comply with Medicare and Medicaid coverage data bank requirements. Subtitle E: Fee Increase - Amends the Tea Importation Act to increase the fee on imported tea to ten cents per hundredweight. Title V: Transportation and Public Works Provisions - Amends the Flood Control Act of 1968 to authorize the Secretary of the Army to establish and collect user fees for developed recreation sites and facilities, campsites, swimming beaches, and boat launching ramps. (Current law prohibits fees for such sites and facilities). Exempts a site or facility with only a boat launch ramp and a courtesy dock. (Sec. 5001) Prohibits the Secretary from establishing or collecting fees for use or provision of drinking water, wayside exhibits, roads, scenic drives, overlook sites, picnic tables, toilet facilities, surface water areas, undeveloped or lightly developed shoreland, or general visitor information. Limits the user fee for the sites or facilities to three dollars a day for each private noncommercial vehicle transporting not more than eight persons (including the driver). (Excludes an overnight camping site or facility or any other site or facility or any other site at which a fee is being charged for its use as of the date of enactment of this Act). Authorizes the Secretary to adjust annually such limitation for changes in the Consumer Price Index of All Urban Consumers. Title VI: Communications Licensing and Spectrum Allocation Improvement - Amends the National Telecommunications and Information Administration Organization Act to require the Assistant Secretary of Commerce for Communications and Information and the Chairman of the Federal Communications Commission (FFC) to meet at least biannually to conduct joint spectrum planning with respect to: (1) the extent to which licenses for spectrum use can be issued pursuant to the Communications Act of 1934 (the Act) to increase Federal revenues; (2) future spectrum requirements for public and private uses and the allocation actions to accommodate those uses; and (3) actions to promote the efficient use of the spectrum. (Sec. 6001) Directs the Secretary of Commerce to report to the President and the Congress identifying and recommending for reallocation bands of frequencies that: (1) are allocated on a primary basis for Federal use; (2) are not required for present or identifiable future needs of the Government; (3) can be made available for use under the Act; (4) will not result in excessive cost to the Government or loss of services or benefit to the public if transferred; and (5) are most likely to have productive uses and public benefits. Requires the Secretary to: (1) report to the President, the Congress, and the FCC, with an opportunity for public comment, a preliminary identification of reallocable bands of frequencies which meet certain criteria established by this Act; and (2) identify and recommend immediate reallocation of such frequencies that in the aggregate span not less than 50 megahertz, which meet the same criteria, and that can be made available immediately upon the issuance of the report. Directs the President, after receipt of the Secretary's recommendations, to: (1) withdraw the assignment of appropriate frequencies no longer needed by the Government; (2) limit the assignment to a Federal station of any frequency which the report recommends be made available immediately for mixed use; (3) withdraw or limit the assignment to a Federal station for mixed use on the delayed effective date pursuant to this Act; (4) assign other frequencies to Federal stations; and (5) provide notice of his actions to the FCC and the Congress. Authorizes the President to substitute alternative frequencies for withdrawals or limitations under certain conditions. Directs the FCC to issue rules for the allocation of all frequencies made available for immediate reallocation under this Act. Authorizes the President to reclaim reassigned frequencies for reassignment to Federal stations. (Sec. 6002) Amends the Act to empower the FCC to use a system of competitive bidding in the granting of licenses filed with the FCC involving the use of the electromagnetic spectrum (public airwaves). Outlines provisions concerning: (1) uses to which such bidding may apply; (2) establishment by the FCC of a competitive bidding methodology; (3) alternative payment schedules (for the use of such airwaves), performance requirements, and equitable area designations and bandwidth assignments; (4) bidder and licensee qualifications; (5) rules of construction; (6) certain limitations with respect to band allocation decisions; (7) revenue uses; (8) termination of the authority to grant licenses or permits under competitive bidding on September 30, 1998; and (9) a public inquiry by the FCC with respect to the results of the competitive bidding process. Revises the FCC's regulatory authority in the management of mobile communications services. Considers a person engaged in the provision of commercial mobile services to be a common carrier and, therefore, required to establish physical connections with such service as required under the Act. Prohibits a person engaged in private mobile service from being considered as a common carrier for such purposes. Prohibits any State or local government from imposing any rate or entry regulation upon any commercial or private mobile service, but allows a State to regulate other terms and conditions of commercial mobile service, under certain conditions. Provides certain FCC deadlines with respect to rules, licenses, and permits for personal communications services, mobile service programs, and the use of the electromagnetic spectrum through the random selection process. (Sec. 6003) Authorizes the FCC to assess and collect regulatory fees to recover its costs for enforcement, policy, rulemaking, and international activities and user information services. Title VII: Nuclear Regulatory Commission Provisions - Amends the Omnibus Budget Reconciliation Act of 1990 to extend from September 1995 to September 1998 the authority of the Nuclear Regulatory Commission to collect annual charges. Title VIII: Patent and Trademark Fees - Amends the Omnibus Budget Reconciliation Act of 1990 to extend through FY 1998 the authorization for the collection of surcharges for use of the Patent and Trademark Office. Establishes the amounts that should be collected through such surcharges for FY 1996 through 1998. Title IX: Merchant Marine Provisions - Amends Federal law relating to shipping to extend the years during which certain tonnage duties are imposed. Title X: Natural Resource Provisions- Subtitle A: Recreation Use Fees - Amends the Land and Water Conservation Fund Act of 1965 to: (1) authorize the charging of admission fees at National Conservation Areas, National Monuments, National Volcanic Monuments, National Scenic Areas, and no more than 21 areas of concentrated public uses; (2) authorize a one-time charge of ten dollars for a Golden Age Passport (currently, such permit is issued without charge); (3) prohibit a recreation fee solely for the use of a picnic table; (4) repeal provisions prohibiting a recreation fee for the use of boat ramps and barring a Federal ageny, at each lake or reservoir under the jurisdiction of the Corps of Engineers where camping is permitted, from charging a user fee for providing at least one primitive campground containing designated campsites, sanitary facilities, and vehicular access; (5) authorize the Secretaries of Agriculture and of the Interior to withhold from a special account made up of user fees an amount determined to be equal to the additional fee collection costs for each fiscal year unless the cost exceeds 15 percent of all fees collected for that year; (6) direct the Secretary of the Interior to establish and collect fees on commercial tour vehicles entering units of the National Park System in which fees are authorized (including aircraft, under specified conditions); and (7) authorize the Secretaries to allow businesses and other organizations to sell and collect fees for the Golden Eagle Passport (an admission passport valid for a 12-month period from the date the annual fee is paid). (Sec. 10003) Directs the Secretaries, for FY 1994, to assess and collect annual charges for the utilization of existing radio, television, and commerical telephone transmission communication sites located on Federal lands administered by the Forest Service and the Bureau of Land Management. Subtitle B: Hardrock Mining Claim Maintenance Fee - Mandates the payment of a specified claim maintenance fee by the holder of an unpatented mining claim, mill, or tunnel site in lieu of certain assessment work and related filing requirements. Exempts certain oil shale claims from such requirements. Waives the fees under certain conditions. (Sec. 10102) Requires the locator of an unpatented mining claim, mill or tunnel site to pay a location fee to the Secretary of the Interior. Exacts a forfeiture penalty for failure to pay location and claim maintenance fees. Directs the Secretary of the Interior to adjust the fees to reflect inflation. Subtitle C: Mining Receipts - Amends the Mineral Leasing Act to provide that in calculating the amount to be paid to States for revenues derived from Federal onshore mineral and geothermal steam leasing receipts, 50 percent of the portion of the appropriation allocable for administration and enforcement shall be deducted from those receipts in approximately equal amounts each month prior to their division and distribution between the States and the Federal Government. Title XI: Civil Service and Post Office Provisions - Subtitle A: Civil Service - Delays by three months the cost-of-living adjustments (COLAs) scheduled to take effect under certain Federal employee retirement systems (including the Civil Service and Federal Employees' Retirement Systems) during FY 1994 through 1996. (Sec. 11002) Amends specified Federal law to: (1) permanently eliminate the lump-sum retirement option beginning on October 1, 1994, except for Federal employees with a life-threatening affliction or other critical medical condition; (2) require plans under the Federal Employee Health Benefit Program (FEHBP) which pay for covered health care services on a fee-for-service basis to apply the Medicare part B (Supplementary Medical Insurance) limitations on payments for physician services when FEHBP benefits for those services are provided to retired FEHB enrollees age 65 or older who do not participate in Medicare part B; (3) provide for a permanent actuarial reduction in a retiree's annuity in the case of retirees who marry after retirement and elect survivor benefits; and (4) provide for a temporary extension and modification of the method for determining Government contributions under FEHBP in the absence of a Government-wide indemnity benefit plan. Subtitle B: Postal Service - Directs the U.S. Postal Service, in addition to other required payments, to pay certain amounts into the Civil Service Retirement and Disability Fund and the Employees Health Benefits Fund in specified minimum increments each fiscal year from FY 1996 through 1998. Title XII: Veterans' Affairs Provisions - Veterans Reconciliation Act of 1993 - Amends the Omnibus Budget Reconciliation Act of 1990 to extend through September 30, 1998: (1) the requirement that veterans with a certain minimum income level make copayments in exchange for receiving certain health care benefits through the Department of Veterans Affairs; (2) the requirement of a minimal copayment for medications received by certain veterans on an outpatient basis; (3) the authority of the United States to recover from third party insurers the cost of certain care and services provided to veterans through the Department; (4) the authority of the Secretary of Veterans Affairs to obtain certain financial information of veterans for income verification purposes; (5) a monthly pension limitation for certain recipients of nursing home care covered under Medicaid; and (6) certain procedures applicable to liquidation sales on defaulted home loans to veterans which were guaranteed by the Department. (Sec. 12007) Increases the home loan fee charged to veterans for loans guaranteed by the Department in the case of loans closed after September 30, 1993, and before October 1, 1998. (Sec. 12008) Reduces the FY 1994 cost-of-living adjustment in dependency and indemnity compensation rates by 50 percent of that provided under law. Provides an identical reduction for cost-of living adjustments with respect to educational assistance benefits payable to active-duty and reserve personnel under the Montgomery GI Bill educational assistance program. Title XIII: Revenue, Health Care, Human Resources, Income Security, Customs and Trade, Food Stamp Program, and Timber Sale Provisions - Chapter 1: Revenue Provisions - Revenue Reconciliation Act of 1993 - Subchapter A: Training and Investment Incentives - Extends until December 31, 1994 the tax exclusion for employer-provided educational assistance and the targeted jobs credit. (Sec. 13111) Extends the credit for increasing research activities until June 30, 1995. Extends the credit for clinical testing expenses for certain drugs for rare diseases or conditions until December 31, 1994. Modifies the fixed base percentage of the research credit for startup companies for taxable years after 1993. (Sec. 13113) Allows a taxpayer other than a corporation to exclude from gross income 50 percent of gain from the sale or exchange of qualified small business stock held for more than five years. Sets forth rules and limitations for such exclusion. Treats one-half of such exclusion as an item of tax preference for minimum tax purposes. (Sec. 13114) Allows the rollover of gain from the sale of publicly traded securities into specialized small business investment companies. (Sec. 13115) Eliminates the depreciation adjustment for computing adjusted current earnings for such property. (Sec. 13116) Increases the dollar limitation on the election to expense certain depreciable business assets. (Sec. 13121) Provides a complete tax exemption (currently a 75 percent tax exemption) for bonds used to finance high-speed intercity rail facilities. (Sec. 13122) Makes permanent the authority to issue qualified small issue bonds to finance manufacturing facilities and farm property. (Sec. 13131) Modifies certain rules for the earned income credit and repeals the supplemental young child credit and the supplemental health insurance credit. Revises credit and phaseout percentages for 1994. (Sec. 13141) Makes permanent and modifies: (1) the authority to issue qualified mortgage bonds and qualified mortgage credit certificates; and (2) the low-income housing credit. (Sec. 13143) Provides for the treatment of rental real estate activities under the limitations on losses from passive activities. (Sec. 13144) Modifies exceptions to the exclusion of real property acquired by a qualified organization from the meaning of acquisition indebtedness. Makes certain exceptions inapplicable to sales out of foreclosure by a financial institution. (Sec. 13145) Repeals the special rule for publicly traded partnerships with respect to the treatment of unrelated business taxable income. (Sec. 13146) Permits a tax-exempt title-holding company to receive unrelated business taxable income if the unrelated income is incidentally derived from the holding of real property. (Sec. 13147) Excludes from unrelated business taxable income: (1) gains from the sale, exchange or other disposition of real property acquired from financial institutions that are in conservatorship or receivership; and (2) loan commitment fees and certain option premiums. Provides for the tax treatment of pension fund investments in real estate investment trusts. (Sec. 13150) Modifies exceptions to the exclusion of real property acquired by a qualified organization from the meaning of acquisition indebtedness. Makes certain exceptions inapplicable to sales out of foreclosure by a financial institution. (Sec. 13151) Increases the depreciation recovery period for nonresidential real property. (Sec. 13161) Repeals the luxury excise tax on boats, aircraft, jewelry, and furs. Modifies the luxury excise tax on automobiles to index the threshold for inflation occurring after 1993 and make such tax applicable to the first retail sale. (Sec. 13162) Exempts from the luxury excise tax parts for accessories installed for use of passenger vehicles by disabled individuals. (Sec. 13163) Extends the current diesel fuel excise tax to diesel fuel used by noncommercial motorboats. Retains such taxes in the General Fund of the Treasury. (Sec. 13171) Repeals the tax preference for the appreciated property charitable deduction. Disallows an adjustment related to the earnings and profits effects of any charitable contribution from being made in computing adjusted current earnings. (Sec. 13172) Establishes substantiation requirements for charitable contributions of $250 or more. (Sec. 13173) Sets forth disclosure requirements for an organization that receives a quid pro quo contribution (payment made partly as a contribution and partly in consideration for goods or services provided to the payor by the donee organization). Imposes a penalty for faiure to make such disclosure. (Sec. 13174) Provides for the temporary extension of the deduction of health insurance costs of self-employed individuals. Subchapter B: Revenue Increases - Increases the marginal tax rate for certain higher incomes. Imposes a surtax on certain higher incomes. (Sec. 13203) Increases the tentative minimum tax for taxpayers other than corporations. (Sec. 13204) Makes permanent the overall limitation on itemized deductions and the phaseout of personal exemptions for high-income taxpayers. (Sec. 13206) Sets forth provisions to prevent the conversion of ordinary income to capital gain in certain financial transactions. Repeals certain exceptions to market discount rules. Provides for the treatment of purchases of stripped preferred stock after April 30, 1993. Revises the methods of: (1) computing the limitation on the deductibility of investment interest; and (2) determining substantial appreciation of partnership inventory items. (Sec. 13207) Repeals the limitation on the amount of wages subject to the health insurance employment tax. (Sec. 13208) Increases and makes permanent the highest estate and gift tax rate. (Sec. 13209) Reduces the deduction for business meals and entertainment expenses. (Sec. 13210) Disallows a tax deduction for social club memberships dues, except for employee recreational expenses. (Sec. 13211) Disallows a tax deduction as a trade or business expense for certain employee remuneration in excess of $1 million. (Sec. 13212) Reduces the compensation taken into account in determining contributions and benefits under qualified retirement plans. (Sec. 13213) Modifies the deduction for moving expenses. (Sec. 13214) Revises the limitation on using the preceding year's tax to calculate an individual's estimated tax payments. (Sec. 13215) Increases the amount of social security and tier 1 railroad retirement benefits to be included in the gross income of certain taxpayers. (Sec. 13221) Increases the tax rate for corporate income in excess of $10 million and the tax rate on personal service corporations. (Sec. 13222) Denies a tax deduction for lobbying expenses. Subjects lobbying organizations to special reporting requirements. (Sec. 13223) Requires any security which is inventory in the hands of the dealer to be included in inventory at its fair market value. Requires any dealer in securities that holds any security which is not in inventory at the close of any taxable year to: (1) recognize gain or loss as if the security were sold on the last business day of the taxable year; and (2) take into account any such gain or loss for such year (the mark-to-market requirement). (Sec. 13224) Requires taking into account: (1) certain Federal Savings and Loan Insurance Corporation (FSLIC) assistance as compensation for loss; and (2) any FSLIC assistance for any debt for determining whether such debt is worthless and in determining the amount of any addition to a reserve for bad debts arising from such worthlessness or partial worthlessness. (Sec. 13225) Increases the required annual payment for corporations that fail to pay estimated income tax. Modifies the periods for applying such annualization. (Sec. 13226) Repeals the stock for debt exception in determining income from discharge of indebtedness. (Sec. 13227) Limits the Puerto Rico and possession tax credit to 40 percent of the possession corporation's qualified possession wages by 1998 and thereafter. (Sec. 13228) Modifies the limitation on corporate deductions for interest paid to related persons to take into account disqualified guarantees of indebtedness and the imposition of a gross basis tax. (Sec. 13231) Requires U.S. shareholders of controlled foreign corporations to include in gross income the lesser of: (1) a pro rata share of such a corporation's excess passive assets; or (2) a pro rata share of such a corporation's applicable earnings. Sets forth rules for determining such amounts. Modifies the rule on taxation of investment in United States property and takes into account excessive passive assets. (Sec. 13233) Excepts from foreign personal holding income any dividend attributable to earnings and profits of the distributing corporation accumulated during any period during which the person receiving such dividend did not hold such stock. Requires the establishment of an excess limitation account by taxpayers who receive foreign tax credits in a year they receive previously taxed earnings and profits. (Sec. 13234) Reduces the amount allowed as allocation and apportionment of research and experimental expenditures from sources within the United States. (Sec. 13235) Excludes passive dividends or interest income from foreign oil and gas income. (Sec. 13236) Modifies accuracy-related penalties for tax underpayments. (Sec. 13237) Denies the inclusion of certain contingent interest in the exemption for portfolio interest for nonresident aliens. (Sec. 13238) Authorizes the Secretary of the Treasury to prescribe regulations recharacterizing any multiple-party financing transactions as a transaction directly among any two or more such parties where appropriate to prevent any tax avoidance. (Sec. 13239) Provides that export property eligible for certain incentives does not include any unprocessed softwood timber for purposes of: (1) taxation of foreign sales corporations (FSCs); and (2) taxation of domestic international sales corporations (DISCs). Requires any income from the sale of such unprocessed timber which was cut from an area in the United States to be sourced in the United States. Repeals the deferral for income of the controlled foreign corporation from sales or milling (outside the United States) of unprocessed software timber to the extent that any controlled foreign corporation is owned by ten percent or more U.S. shareholders. (Sec. 13241) Increases the excise tax on gasoline, diesel fuel, aviation fuel, and other transportation fuels. Imposes an excise tax on compressed natural gas used in motor boats or motor vehicles, except school busses and intracity transportation. (Sec. 13242) Imposes an excise tax on diesel fuel (separate from the gasoline tax and the tax on aviation). Exempts from such tax diesel fuel: (1) used by trains and intercity, local, or school busses; and (2) which is dyed or marked in accordance in regulations prescribed by the Secretary of the Treasury. Provides that the Airport and Airway Trust Fund financing rate does not apply to aviation fuel sold by a producer or importer for use by the purchaser in a nontaxable use. Imposes a civil penalty on persons who use reduced-rate fuel for a taxable use. (Sec. 13243) Imposes a floor stocks tax on any person holding diesel fuel on January 1, 1994, subject to stated conditions. (Sec. 13244) Increases the amount to be transferred to the Mass Transit Account from the Highway Trust Fund. (Sec. 13245) Increases the floor stocks tax on commercial aviation fuel held on October 1, 1995. (Sec. 13251) Modifies provisions concerning substantial understatement and return-preparer penalties to allow reasonable cause exceptions. (Sec. 13252) Requires certain financial entities (including the Federal Deposit Insurance Corporation, the Resolution Trust Corporation, and the National Credit Union Administration, and their successors or subunits) to file information returns regarding discharges of indebtedness of $600 or more. (Sec. 13261) Allows an amortization deduction with respect to certain intangible property, including goodwill, that is acquired and held by a taxpayer in connection with the conduct of a trade or business or an activity engaged in for the production of income. (Sec. 13271) Expands the 45-day interest-free period for refunding tax overpayments to all returns, as well as to amended returns and claims for refunds. Provides that if interest is not refunded within 45 days after the taxpayer files an amended return or claim for refund, interest will be paid only for periods after the date on which the return or claim is filed. (Sec. 13272) Denies the business travel expense deduction for spouses, dependents, or others. (Sec. 13273) Increases the withholding rate for supplemental wage payments. Subchapter C: Empowerment Zones, Enterprise Communities, Rural Development Investment Areas, Etc. - Provides for the designation of 95 tax enterprise communities and nine empowerment zones during calendar years after 1993 and before 1996: (1) by the Secretary of Housing and Urban Development, in the case of an urban area; and (2) by the Secretary of Agriculture in the case of a rural area. Sets forth the eligibility criteria for such designations. Provides for the issuance of enterprise zone facility bonds in enterprise communities and empowerment zones in a manner similar to exempt facility bonds. Allows an empowerment zone employment credit to employers for a percentage of qualified zone wages paid during calendar years 1994 through 2004. Limits the amount of such credit. Increases the limitation on expensing certain depreciable business assets. (Sec. 13311) Allows a general business tax credit for contributions to selected community development corporations to provide employment of, and business opportunities for, low-income indiviuals who are residents of the operational area of the community. (Sec. 13321) Provides for accelerated depreciation for property on Indian reservations. (Sec. 13322) Allows businesses an employment credit for a percentage of qualified wages and health insurance costs of Indian employees. Subchapter D: Other Provisions - Extends the authority to disclose tax return information to the Department of Veterans Affairs through September 30, 1998. (Sec. 13402) Authorizes the disclosure of certain tax return information to: (1) the Department of Education to implement the direct student loan program; and (2) to the Department of Housing for income verification under certain housing programs. (Sec. 13411) Increases the public debt limit and repeals the temporary limit on such increase. (Sec. 13421) Makes permanent: (1) the excise tax on certain vaccines; and (2) the authority to pay compensation from the Vaccine Trust Fund under the National Vaccine Injury Compensation Program for certain damages resulting from vaccines administered after September 30, 1988. Imposes a floor stocks tax on taxable vaccines. (Sec. 13422) Requires continuation coverage under group health plans of the costs of pediatric vaccines. (Sec. 13431) Provides special rules with respect to the nonrecognition of gain for principal residences compulsorily or involuntarily converted as a result of a presidentially-declared disaster. (Sec. 13441) Increases the amount taxpayers may designate to the Presidential Election Campaign Fund. (Sec. 13442) Disallows employer deductions for amounts paid or incurred in connection with a group health plan if the plan fails to reimburse hospitals for inpatient services provided in New York at the same rate that licensed commercial insurers are required to reimburse hospitals for inpatient services for individuals not covered by a group health plan. (Sec. 13443) Allows a general business credit for food or beverage establishments equal to the excess employers social security tax obligations. Defines excess social security tax as social security taxes which have been paid by an employer with respect to specified tips received by an employee. (Sec. 13444) Sets forth restrictions on the disclosure of tax information to State and local agencies with respect to death certificates. Chapter 2: Health Care, Human Resources, Income Security, and Customs and Trade Provisions - Subchapter A: Medicare - Part 1: Provisions Relating to Part A: - Amends title XVIII (Medicare) of the Social Security Act (SSA) to: (1) reduce and otherwise revise certain prospective payment system (PPS) and other factors used in updating payments to hospitals for inflation (including factors used in updating inflationary payments for sole community and Medicare-dependent, small rural hospitals); (2) prohibit the Secretary of Health and Human Services (Secretary) from considering such reductions in granting exceptions or adjustments to target amounts for PPS-exempt hospitals; (3) require the Secretary, for post-FY 1993 discharges, to reduce the Federal rate for hospital capital expenses and, for hospital cost reporting periods beginning in FY 1994, redetermine which capital payment methodology should be applied to take into account such reduction; (4) extend additional payments (although modified) to Medicare-dependent, small rural hospitals which serve a disproportionate share of low-income patients; (5) delay inflationary updates in skilled nursing facility (SNF) cost limits; (6) reduce the factors used in updating payments to hospices for inflation; (7) consider intern and resident services performed in a hospital-owned or-controlled community health center whose costs are incurred by the hospital in determining any additional payments to the hospital for indirect medical education costs; and (8) reduce the Medicare part A (Hospital Insurance) premium, on a phased-in graduated basis, for certain individuals credited with 30 or more quarters of social security coverage and their spouses. (Sec. 13501) Continues the regional referral center classification of hospitals so classified as of September 30, 1992, unless the hospital's location is redesignated as a metropolitan area by the Office of Management and Budget. Prohibits the Secretary from updating the cost limits for SNF cost reporting periods beginning in FY 1994 and 1995 or the prospective payment amounts for SNF services rendered during such periods, except if necessary to take into account repeals by this Act of payments for excess overhead costs and return on equity capital. (Sec. 13505) Amends the Omnibus Budget Reconciliation Act of 1989 (OMBRA '89) to extend additional payments for hemophilia clotting factor furnished through FY 1994. (Sec. 13507) Amends the Omnibus Budget Reconciliation Act of 1990 (OMBRA '90) to require the Secretary to continue until at least July 1, 1997, any demonstration project of limited-service rural hospitals with respect to which the Secretary has enter into an agreement prior to enactment of OMBRA '89. Part II: Provisions Relating to Part B - Subpart A: Physicians' Services - Amends SSA title XVIII to: (1) reduce the default update in 1994 for surgical and non-surgical services (except primary care services); (2) include anesthesia services in the surgical services category for purposes of calculating both Medicare volume performance standards (MVPS) starting in FY 1994 and the conversion factor update starting in 1996; (3) increase the performance standard factor; (4) double the maximum allowable reduction permitted in the default update formula in 1994 for services within the physicians' services category; (5) require the Secretary to phase-in reductions (but not below a certain level) to the practice expense relative value units (RVUs) for certain physicians' services on a graduated basis starting in 1994; (6) repeal the prohibition on separate payment for interpretation of electrocardiograms (EKGs) and require the Secretary to make separate payment for interpretation of any performed or ordered in conjunction with a visit to or a consultation with a physician; (7) repeal the reductions in payments to new physicians and practitioners; (8) revise payment policy with respect to medically directed certified registered nurse anesthetists (CRNAs) and anesthesia care teams starting in 1994, with the fee for services divided equally between the supervising anesthesiologist and attending CRNA; (9) apply the five percent differential between payments to participating and nonparticipating physicians and suppliers and limiting charge restrictions to the technical components of nonphysician services paid on the basis of the physician fee schedule, services of nonparticipating suppliers or other persons who furnish a physician's service that is paid under the physician fee schedule, and services that would be paid under the fee schedule but have been excluded from it by the Secretary; and (10) include under the physician fee schedule antigens prepared by a physician for a particular patient. Subpart B: Outpatient Hospital Services - Amends SSA title XVIII to extend the: (1) ten percent reduction in payments for capital-related costs of outpatient hospital services; and (2) 5.8 percent reduction in payments for cost-related outpatient hospital services. Subpart C: Ambulatory Surgical Center Services - Prohibits the Secretary from updating ambulatory surgical center services in FYs 1994 and 1995. (Sec. 13531) Reduces payments for intraocular lenses inserted in an ambulatory surgical center during or subsequent to cataract surgery starting in 1994. (Sec. 13532) Amends SSA title XVIII to extend special payment rates for certain eye or eye and ear hospitals to hospitals that otherwise meet current law criteria but, on October 1, 1987, operated as a physically separate or distinct eye or ear unit of a general acute care hospital which has since disposed of a substantial portion of its other acute care operations. Subpart D: Durable Medical Equipment - Freezes at 1993 levels payments for parenteral and enteral nutrients, supplies, and equipment in 1994 and 1995. (Sec. 13542) Amends SSA title XVIII to: (1) revise the payment rules for items of durable medical equipment (DME), with changes basing national payment limits for DME on the median of local payment amounts; (2) remove aspirators, nebulizers, and certain ventilators (ANVs) from the category of DME items requiring frequent and substantial servicing; (3) provide for separate payment of accessories relating to ANVs as inexpensive or routinely purchased items; (4) subject ostomy supplies, tracheostomy supplies, and urologicals to national payment limits; (5) provide payment for certain surgical dressings in a lump sum equal to 80 percent of the lesser of the actual charge for the item or the national payment; (6) reduce payment for transcutaneous electrical nerve stimulation devices by an additional 30 percent; and (7) freeze payments for orthotics, prosthetics, and prosthetic devices in 1994 and 1995. Subpart E: Other Provisions - Amends SSA title XVIII to: (1) freeze payments for clinical diagnostic laboratory test services in 1994 and 1995 and phase-in a reduction in the national cap on fee schedule amounts for a particular test over a three year period; (2) provide Medicare coverage of oral cancer drugs containing the same active ingredients as Medicare-covered intravenous anticancer drugs; (3) provide Medicare coverage of drugs approved by the Food and Drug Administration (FDA) and used appropriately in an anticancer chemotherapeutic regimen for a medically accepted indication, regardless of whether the drug has been approved by the FDA specifically for such use, as long as such use is supported either by clinical evidence in peer reviewed medical literature or by one or more of three specified major medical compendia; (4) extend Medicare coverage to certified nurse-midwife services without regard to when in the maternity cycle they are performed; (5) increase the annual cap on the amount of Medicare payment for covered outpatient physical and occupational therapy services; and (6) treat as Federally Qualified Health Centers any outpatient health programs and facilities operated by a tribe or tribal organization under the Indian Self-Determination Act or by an urban Inian organization receiving certain funds under the Indian Health Care Improvement Act. (Sec. 13552) Amends the Omnibus Budget Reconciliation Act of 1986 (OMBRA '86) to extend Alzheimer's disease demonstration projects for an additional year. (Sec. 13557) Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 to: (1) extend the waivers for four municipal health service demonstration projects through calendar 1997; and (2) require the Health Care Financing Administration (HCFA) study mandated under OMBRA '89 to consider costs to Medicaid and other payers, access to care, outcomes, beneficiary satisfaction, and utilization differences among the different populations served by the projects. Part III: Provisions Relating to Parts A and B - Amends SSA title XVIII and the Internal Revenue Code (IRC) to make changes with regard to Medicare as secondary payer, extending requirements for: (1) employer responses to carrier inquiries; (2) Internal Revenue Service (IRS) and Social Security Administration disclosure of certain taxpayer information; and (3) disabled beneficiaries and beneficiaries with end stage renal disease. Details employer aggregation rules, and revises certain group health plans requirements. (Sec. 13561) Exempts retroactively certain Medicare secondary payer situations involving members of religious orders who are considered "deemed employees" because of an election of social security coverage. (Sec. 13562) Amends SSA title XVIII to: (1) extend as well as grant new exceptions to the prohibition against referral of Medicare patients to clinical laboratories in which the referring physician (or his or her immediate family members) have a financial relationship; (2) revise provisions for payment of the direct costs of graduate medical education (GME): (3) extend to three years (on a graduated basis) the current one-year period following a transplant procedure during which Medicare covers immunosuppressive drug therapy for Medicare organ transplant recipients; (4) reduce payments for erthropoietin (EPO); (5) permit all dialysis patients to self-administer EPO; and (6) establish new standards for payment of Medicare claims. (Sec. 13564) Prohibits the Secretary from making any changes in home health services cost limits (including adjustments for changes in the applicable wage index) for cost reporting periods between July 1, 1994, and July 1, 1996, except as necessary to take into account elimination by this Act of additional payments for administrative and general costs of hospital-based home health agencies. Requires the Secretary to limit any exception to cost limits to the amount that would have been granted if there were no restriction on changes in the cost limits. (Sec. 13567) Amends the Omnibus Budget Reconciliation Act of 1987 (OMBRA '87) and the Deficit Reduction Act of 1984 to: (1) extend social health maintenance organization (SHMO) demonstrations for an additional two years; and (2) permit one of the SHMO demonstrations to enroll Medicare end stage renal disease beneficiaries. Prohibits the Secretary from imposing a limit of less than 12,000 on the number of individuals that may participate in a SHMO demonstration. (Sec. 13569) Amends OMBRA' 86 to extend for two years the Watts Health Foundation's waiver from the requirement that not more than half of its enrollees can be Medicare or Medicaid beneficiaries. Part IV: Provisions Relating to Part B Premium - Amends SSA title XVIII to extend current law provisions for establishing the monthly Medicare part B premium for beneficiaries enrolled in Medicare. Part V: Provisions Relating to Data Bank - Amends part A (General Provisions) of SSA title XI to require the Secretary to establish a Medicare and Medicaid Coverage Data Bank (containing certain information reported by employers about individual employee group health plan coverage) for purposes of identifying and collecting from responsible third parties any amounts owed to reimburse Medicare or Medicaid for health care items and services furnished to their beneficiaries. Subchapter B: Medicaid - Part I: Services - Amends SSA title XIX (Medicaid) to: (1) allow States to cover personal care services otherwise authorized in accordance with a service plan approved by the State without such services having to be supervised by a registered nurse; (2) permit States under the prescription drug rebate program to operate prescription drug formularies meeting certain requirements; (3) repeal the weighted average manufacturer price inflation formula for calculating additional drug rebates; (4) prohibit imposition of prior State authorization controls with respect to new drugs during the first six months following FDA approval; (5) allow States to cover prescribed drugs, directly observed therapy, and other specified services for low-income individuals infected with tuberculosis; (6) specify that emergency services for illegal aliens for which Federal Medicaid matching funds are available under current law do not include care and services related to organ transplant procedures; (5) expand the scope of required nurses midwife services to include services outside the maternity cycle that midwives may perform under State law; and (6) designate entities treated as comprehensive federally funded health centers for Medicare part B purposes as federally qualified health centers for Medicaid purposes. Part II: Eligibility - Amends SSA title XIX to revise provisions regarding liens, adjustments, and recoveries and transfers of assets, with changes: (1) requiring States to recover the costs of nursing facility or other long-term services furnished to Medicaid beneficiaries from their estates (with hardship procedures for waiver of recovery where undue hardship would result); (2) providing for a delay in Medicaid eligibility for institutionalized individuals (or their spouses) who dispose of assets for less than fair market value on or after a specified look-back date; and (3) establishing rules for the treatment of funds and other assets of an individual placed in trust by or on behalf of an individual (or the individual's spouse) for purposes of Medicaid eligibility. Part III: Payments - Amends SSA title XIX to make various changes to assure proper payments to disproportionate share hospitals (DSHs), including changes with regard to DSH Medicaid inpatient utilization rates. Requires States to enact laws: (1) prohibiting insurers (including group health plans under the Employment Retirement Income Security Act of 1974 (ERISA), service benefit plans, and health maintenance organizations (HMOs)) from taking Medicaid status into account in enrollment or payment of benefits; (2) giving States the right to payments by liable third parties; and (3) ensuring the compliance of insurers and employers in the carrying out of court and administrative orders for medical child support. Applies to Medicaid the Medicare rules regarding limitations on physician ownership and referral. Requires States to operate their State Medicaid fraud control units (FCUs) effectively in accordance with established standards, unless they demonstrate that such operation is not cost-effective due to minimal fraud and existing beneficiary protection against abuse and neglect in connection with Medicaid assistance provided without a FCU. Part IV: Immunizations - Amends SSA title XIX to: (1) require State Medicaid plans to provide for a program meeting specified requirements for the distribution of federally purchased pediatric vaccines to program-registered providers for the immunization of vaccine-eligible children without charge; (2) provide for pediatric vaccination outreach and education; and (3) treat certain Indian health care providers and public housing health centers as federally-qualified health centers for Medicaid purposes. (Sec. 13631) Freezes coverage of the costs of pediatric vaccines under certain group health plans. (Sec. 13632) Amends the Public Health Service Act to revise the National Vaccine Injury Compensation Program, including changes: (1) requiring additional vaccines on the Vaccine Injury Table, including those recommended by the Centers for Disease Control and Prevention for routine administration to children; (2) authorizing increased appropriations for compensation payments under the Program; and (3) extending the time for special master decisions on petitions for vaccine-related injuries or deaths associated with the administration of certain vaccines. Part V: Miscellaneous - Amends SSA title XI to increase the limits on Federal matching payments for Medicaid programs in Puerto Rico, the Virgin Islands, the Northern Mariana Islands, American Samoa, and Guam, adjusted for inflation in subsequent years. (Sec. 13642) Amends OMBRAs '89 and '90 to extend: (1) the moratorium on the treatment of certain facilities as institutions for mental diseases for purposes of Medicaid reimbursement; and (2) funding periods for Medicaid demonstration projects concerning low-income families, especially pregnant women and children. Amends Medicaid to apply spousal impoverishment eligibility rules to the On Lok frail elderly waiver program. (Sec. 13644) Amends specified Federal law to extend through January 31, 1995, the current waiver of the enrollment mix requirement with respect to the Dayton Area Health Plan. Subchapter C: Human Resources and Income Security Amendments - Part I: Child Welfare Services, Foster Care, and Adoption Assistance - Amends part B (Child-Welfare Services) of SSA title IV to create a capped entitlement program authorized at specified levels through FY 1998 to provide child welfare services designed to strengthen and preserve families. (Sec. 13712) Directs the Secretary to provide grants for State courts to assess and improve proceedings relating to foster care placement and adoption. (Sec. 13713) Amends SSA title IV part E (Foster Care and Adoption Assistance) (FCAA) to: (1) provide for 75 (and later 50) percent matching of State expenditures for planning, design, development, or installation of statewide mechanized data collection and information retrieval systems, and 50 percent matching for system operation; and (2) make permanent the authorization for the independent living program. (Sec. 13715) Amends OMBRA '89 to extend permanently the level of Federal reimbursement under SSA title IV part E for the training of personnel employed or preparing for employment by the State or local child welfare agency, and for the training of foster and adoptive parents. (Sec. 13716) Prohibits the Secretary: (1) until October 1, 1994, from reducing any payment to, withholding payments or seeking any repayments from any State under parts B or E by reason of a determination in connection with a review of State compliance with part B foster care protections; or (2) from reducing any payments to, withholding payments or seeking any repayments from any State under part E by reason of a determination in connection with any on-site Federal financial review, or any audit conducted by the Inspector General using similar methodologies. Part II: Child Support Enforcement - Amends SSA title IV part D (Child Support and Establishment of Paternity) to: (1) set new paternity establishment performance standards for State child support enforcement programs on the basis of a revised paternity establishment percentage; and (2) specify additional procedures for use under State laws to improve the effectiveness of child support enforcement, such as a simple civil process for voluntarily acknowledging. paternity. Part III: Supplemental Security Income - Amends SSA title XVI (Supplemental Security Income) (SSI)and other specified Federal law to: (1) require the Secretary to charge States fees for the Federal cost of administering State supplemental SSI payments; and (2) authorize the Secretary to charge additional fees for services provided upon State request that are beyond the level customarily provided in administering such payments. (Sec. 13732) Amends OMBRA '90 to make permanent the exclusion of State and local relocation assistance from countable income and countable resources under SSI. (Sec. 13733) Amends SSA title XVI to: (1) require that a spouse or parent of family members on SSI who is absent from the household solely because of an active duty military assignment be deemed to be still living in the household; (2) exclude hostile fire pay received on active military duty from countable income under SSI; (3) continue SSI benefits to children who are U.S. citizens if they received SSI in the United States and then accompany their parents on military assignment to any U.S. territory or possession; and (4) require that the current month's Federal SSI benefit amount be used in determining the value of in-kind support and maintenance in calculating the current month's Federal benefit to be paid (thus eliminating the unintended SSI benefit increase for January and February following a COLA and the offsetting reduction for March). (Sec. 13736) Amends Federal law to exempt income of up to $2,000 per year received by individual Indians derived from leases on individually-owned trust or restricted Indian lands in determining eligibility and benefit levels under the SSI and Aid to Families with Dependent Children (SSA title IV part A) (AFDC) programs. Part IV: Aid to Families with Dependent Children - Amends SSA title IV part A to: (1) reduce to 50 percent the enhanced Federal matching available for certain categories of State administrative expenses; and (2) increase the earnings of stepparents disregarded in determining AFDC eligibility and benefit amounts. Part V: Unemployment Insurance - Amends IRC to extend the current Federal unemployment tax rate. Part VI: Social Services in Empowerment Zones and Enterprise Communities - Amends SSA title XX (Block Grants to States for Social Services) to provide funding for additional grants to States for each qualified empowerment zone and enterprise community in the State. Requires States receiving such a grant to use it for social services directed at three goals: (1) achieving or maintaining economic self-support to prevent, reduce, or eliminate dependency; (2) achieving or maintaining self-sufficiency; and (3) preventing or remedying neglect, abuse, or exploitation of children and adults unable to protect their own interests, or preserving, rehabilitating, or reuniting families. Requires States to use such a grant: (1) in accordance with a strategic plan for the zone or community; and (2) on activities that benefit residents of the zone or community. Subchapter D: Customs and Trade Provisions - Part I: Extension of Customs User Fee, GSP, and Trade Adjustment Assistance Programs - Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) to extend the authority of the Secretary of the Treasury to collect customs user fees through September 30, 1998. (Sec. 13802) Amends the Trade Act of 1974 to remove the Union of Soviet Socialist Republics from the list of countries ineligible for designation as a beneficiary developing country under the Generalized System of Preferences (GSP). Extends duty-free treatment provided under the GSP through September 30, 1994. (Sec. 13803) Extends the worker trade adjustment assistance program (trade adjustment assistance benefits for workers adversely affected by import competition or the relocation of U.S. production facilties abroad), as well as authorization of appropriations for it, from FY 1993 through FY 1998. Limits FY 1997 payments to such workers for job training assistance to $70 million (currently, $80 million for any fiscal year). Part II: Customs Officer Pay Reform - Amends Federal law to revise the pay system for United States Customs Service inspectors (customs inspectors). (Sec. 13811) Amends the Tariff Act of 1930 to prohibit merchandise or passengers from foreign places, or merchandise being transported from one port to another, from being unladen from carrying vehicles during overtime hours (currently, at night). (Sec. 13812) Amends Federal law with regard to the treatment of certain pay of customs officers for retirement purposes. Authorizes cash awards to customs officers for foreign language proficiency. (Sec. 13813) Amends the COBRA to provide for reimbursement of appropriations from the Customs User Fee Account (Account) for agency retirement contributions. Chapter 3: Food Stamp Program - Mickey Leland Childhood Hunger Relief Act - Subchapter A: Ensuring Adequate Food Assistance - Amends the Food Stamp Act of 1977 to exclude the income of elementary and secondary students 21 years old or younger for purposes of food stamp program (program) eligibility and benefits. (Sec. 13912) Removes the excess shelter deduction cap after a specified period of interim caps. (Sec. 13913) Excludes earned income tax credits from family resource determinations for one year following receipt. (Sec. 13914) Excludes third party payments for transitional housing for the homeless from income determinations. (Sec. 13915) Excludes general assistance vendor payments from income determinations. (Sec. 13916) Eliminates program reductions for certain reapplying households. (Sec. 13917) Increases funding levels for Puerto Rico block grants. Subchapter B: Promoting Self-Sufficiency - (Sec. 13921) Treats child support payments to non-household members as a deduction for program eligibility purposes. (Sec. 13922) Increases and makes age-based dependent care deduction amounts. Eliminates the $160 monthly cap on dependent care reimbursement for employment and training program participants. (Sec. 13923) Increases annually the fair market value of vehicles that program participants may own. (Sec. 13924) Excludes from financial resources the value of a vehicle a household depends upon to carry heating fuel or water for home use when transported fuel or water is the household's primary source of such item. (Sec. 13925) Directs the Secretary of Agriculture to establish demonstrating projects testing resource accumulation. Subchapter C: Simplifying the Provision of Food Assistance - Permits related adults living in the same household to apply for separate program benefits under specified conditions. (Sec. 13932) Extends program eligibility to children living with program participating parents in a drug or alcohol rehabilitation center. Subchapter D: Improving Program Integrity - Authorizes the use of program recipient information by other Federal agencies to collect coupon overissuance from Federal salaries or pensions. (Sec. 13942) Disqualifies a recipient from program participation: (1) for one year for trading controlled substances for coupons; and (2) permanently for the second occasion of trading controlled substances for coupons, or for the first occasion of trading firearms, ammunition, or explosives for coupons. (Sec. 13943) Applies the civil money penalty cap for stores trafficking in coupons or selling coupons for firearms or controlled substances to violations during a single investigation rather than a two-year period. Subchapter E: Improving Food Stamp Program Management - Revises provisions with regard to claims collection and quality control (error rates). Subchapter F: Uniform Reimbursement Rates - Reduces to 50 percent Federal cost-sharing of program expenses for: (1) investigations and prosecutions; and (2) the immigration status verification system. Includes automated data processing and information retrieval systems among eligible cost-sharing activities. (Sec. 13962) Directs the Secretary of the Treasury to pay to the Secretary specified sums for each of FY 1994 through 1996 for the purchase, processing, and distribution in two States of additional specified commodities. Subchapter G: Implementation and Effective Dates - Sets forth specified implementation and effective dates. Chapter 4: Timber Sales - Provides for a new payment calculation for FY 1994 through 2003 for payments to counties in the States of: (1) Washington, Oregon, and California in which national forests are situated and which are affected by decisions related to the northern spotted owl; and (2) Oregon and California sharing BLM timber sales receipts. Title XIV: Budget Process Provisions - Amends the Congressional Budget Act to prescribe enforcement mechanisms for discretionary spending limits for FY 1996 through 1998. Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to extend pay-as-you-go provisions through FY 1998.

TABLE OF CONTENTS: Title I: Committee on Agriculture, Nutrition, and Forestry Subtitle A: Commodity Programs Subtitle B: Restructuring of Loan Programs Subtitle C: Food Stamp Program Subtitle D: Agricultural Trade Subtitle E: Miscellaneous Title II: Committee on Armed Services Title III: Committee on Banking, Housing, and Urban Affairs Title IV: Communications and Transportation Subtitle A: Spectrum Allocation and Auction Subtitle B: Vessel Tonnage Duties Title V: Committee on Energy and Natural Resources Subtitle A: Recreation and Commercial Use Fees Subtitle B: Hardrock Mining Claim Maintenance Fee Subtitle C: Commonwealth of Northern Mariana Islands Agreement Subtitle D: Mineral Receipts Title VI: Committee on Environment and Public Works Title VII: Finance Committee Reconciliation Provisions Relating to Medicare, Medicaid, and Other Programs Subtitle A: Medicare Subtitle B: Medicaid Program Subtitle C: Income Security Programs Subtitle D: Miscellaneous Provisions Title VIII: Revenue Provisions Subtitle A: Training and Investment Incentives Subtitle B: Revenue Increases Subtitle C: Miscellaneous Title IX: Committee on Foreign Relations Title X: Committee on Governmental Affairs Subtitle A: Civil Service Subtitle B: Postal Service Title XI: Judiciary Title XII: Committee on Labor and Human Resources Subtitle A: Student Loan Provisions Subtitle B: Public Health Service Act Provisions Subtitle C: Improved Immunization Delivery and Monitoring Subtitle D: ERISA Amendments Title XIII: Veterans' Programs Title I: Committee on Agriculture, Nutrition, and Forestry - Agricultural Reconciliation Act of 1993 - Subtitle A: Commodity Programs - Amends the Agricultural Act of 1949 to reduce, with specified exceptions, the acreage eligible for deficiency payments from 92 percent to 85 percent for wheat, feed grains, upland cotton, and rice. (Sec. 1105) Extends the dairy support program. Sets forth purchase price ceilings for butter and nonfat dry milk. Reduces milk prices by ten cents per hundredweight for 1996. Prohibits the sale of bovine growth hormone during a specified time period. (Sec. 1106) Amends the Agricultural Adjustment Act of 1938 to require domestic cigarette manufacturers to certify the amount of U.S.-produced tobacco in their products. Establishes a domestic marketing assessment. Requires domestic cigarette manufacturers to purchase specified amounts of Burley and Flue-cured tobacco from producer-owned cooperatives. Amends the Agricultural Act of 1949 to require importers of foreign tobacco to pay: (1) specified marketing assessments; and (2) specified assessments to the No Net Cost Tobacco Fund. Amends the Tobacco Adjustment Act of 1983 to subject imported tobacco to inspection fees on the same basis as domestic tobacco. Amends the Agricultural Adjustment Act of 1938 to extend quota reduction floor authority (with waiver authority to avoid excess inventories) for Burley and Flue-cured tobacco. (Sec. 1107) Increases 1995 and 1996 sugarcane and sugarbeet marketing assessment rates. (Sec. 1108) Reduces 1994 and 1995 loan levels for soybeans and oilseeds. Revises loan maturation provisions. Eliminates loan origination fees for post-1993 crop years. (Sec. 1109) Increases 1994 and 1995 peanut marketing assessment and first purchaser-producer assessment rates. (Sec. 1110) Reduces 1994 through 1997 honey price support levels and individual payment ceilings. (Sec. 1111) Amends the National Wool Act of 1954 to reduce 1995 through 1997 wool and mohair individual payment ceilings. Maintains the 1993 support price for shorn wool through 1997. Eliminates specified marketing assessments. Subtitle B: Restructuring of Loan Programs - Amends the Rural Electrification Act of 1936 to restructure Rural Electrification Administration electric and telephone loan programs, including the establishment of: (1) electric hardship loans and municipal rate loans; and (2) telephone hardship loans and cost-of-money loans. Authorizes specified appropriations for FY 1994 through 1998. Revises the definition of "rural area" for purposes of rural electrification and telephone service. Amends the Consolidated Farm and Rural Development Act to permit electric and telephone borrowers to qualify for: (1) water and waste disposal loans; and (2) rural economic development assistance. Subtitle C: Food Stamp Program - Amends the Food Stamp Act of 1977 to reduce to 50 percent Federal cost-sharing expenses for: (1) food stamp investigations and prosecutions; and (2) immigration status verifications under the Social Security Act. Includes automated data processing and information retrieval systems among eligible cost-sharing activities. Subtitle D: Agricultural Trade - Amends the Agricultural Trade Act of 1978 to eliminate required FY 1994 and 1995 additional funding levels for the market promotion program and obligate certain sums for specified categories of exporters. (Sec. 1402) Amends the Omnibus Budget Reconciliation Act of 1990 to: (1) remove specified acreage reduction requirements for grain sorghum and barley; and (2) eliminate certain support level adjustment provisions. (Sec. 1403) Amends the Agricultural Trade Act of 1978 to prohibit the entry into, or the withdrawal from a warehouse of any imported wheat or barley that it is not covered by an end-use certificate. (Sec. 1404) Expresses the sense of the Congress that the Secretary of Agriculture should aggressively promote the export of vegetable oil. Subtitle E: Miscellaneous - Amends the Federal Crop Insurance Act to direct the Federal Crop Insurance Corporation to take specified actions to improve the actuarial soundness of Federal crop insurance coverage. (Sec. 1502) Amends the Food Security Act of 1985 with regard to the conservation reserve program to: (1) make the current discretionary enrollment provision mandatory; and (2) reduce acreage requirements. Extends the wetlands reserve program and revises acreage enrollment provisions. (Sec. 1503) Authorizes the Secretary of Agriculture to charge admission, entrance, and recreation fees at appropriate sites, and public or recreation areas. (Sec. 1504) Expresses the sense of the Senate that: (1) farmers should pay no more than their fair share of any budget reduction necessary to achieve deficit reduction; and (2) the level of budget reduction should take into account taxes, interest rates, and user fees. Title II: Committee on Armed Services - Directs the Secretary of Defense to provide a limited increase in the military retired pay of former military personnel who became members of the armed forces before August 1, 1986. Specifies the month for which such increases becoming effective on December 1 of fiscal years 1994 through 1998 shall be payable as part of retired pay. Title III: Committee on Banking, Housing, and Urban Affairs - Amends the Federal Deposit Insurance Act (FDICA) to prescribe an order of priority for the distribution of amounts realized from the resolution of any insured depository institution. (Sec. 3002) Amends the Federal Reserve Act to mandate for FY 1997 and FY 1998 the transfer into the Treasury of specified percentages of the surplus fund of any Federal reserve bank. Prohibits a Federal reserve bank from replenishing its surplus fund by the amount of such transfer. (Sec. 3003) Amends the Stewart B. McKinney Homeless Assistance Amendments Act of 1988 to: (1) include certain Indian housing programs within the parameters of the Department of Housing and Urban Development program; (2) require submission of certain income disclosure consent forms to verify applicant eligibility for benefits; and (3) revise applicant, participant, and public housing agency protections. Amends the United States Housing Act of 1937 to declare that adjustments to a public housing agency's operating subsidy shall reflect actual changes in rental income collections resulting from application of the Stewart B. McKinney Homeless Assistance Amendments Act of 1988. (Sec. 3004) Amends the National Housing Act to direct the Government National Mortgage Association (GNMA) to: (1) charge fees in connection with its multiclass securities guarantee program (the program); (2) take steps to assure that a certain portion of the benefit resulting from the program accrues to mortgagors who execute eligible mortgages; (3) summarize program activities in its annual report; and (4) report to certain congressional committees on specified risk minimization aspects of the program. (Sec. 3005) Directs the Secretary of Housing and Urban Development to increase the rate at which the Secretary earns the single premium payment collected at the time of insurance of a mortgage that is an obligation of the Mutual Mortgage Insurance Fund. Title IV: Communications and Transportation - Subtitle A: Spectrum Allocation and Auction - Emerging Telecommunications Technologies Act of 1993 - Directs the Assistant Secretary of Commerce for Communications and Information and the Chairman of the Federal Communications Commission (FCC) to meet at least biannually to conduct joint spectrum planning with respect to: (1) future spectrum requirements for public and private uses and the allocation actions to accommodate those uses; and (2) actions to promote the efficient use of the spectrum. Directs the Assistant Secretary and the Chairman to report jointly to specialized congressional committees on their recommendations. Requires the FCC to develop procedures to ensure that minority-owned businesses and small businesses are given the opportunity to provide spectrum-based services. Directs the FCC to report to the Congress a study of current and future spectrum needs of State and local government public safety agencies through the year 2010. (Sec. 4004) Directs the Secretary of Commerce to identify radio band frequencies that are allocated on a primary basis for Federal use, are not currently required for Federal needs, can easily be made available for uses, and have the greatest potential for productive uses and public benefits. Directs the Secretary to recommend to the President and the Congress the immediate reallocation of no less than 30 megahertz of such frequencies. Requires a preliminary and final report on other reallocable frequencies, with an opportunity for public comment. (Sec. 4005) Directs the President, after receipt of the Secretary's recommendation, to: (1) withdraw the assignment of appropriate frequencies no longer needed by the Government; (2) assign other frequencies to Federal stations; (3) reallocate for public or mixed use appropriate frequencies; and (4) provide notice of his actions to the FCC and the Congress. Authorizes appropriations. (Sec. 406) Directs the FCC to issue rules for the allocation of all frequencies made available for immediate reallocation under this Act. Authorizes the President to reclaim reassigned frequencies for reassignment to Federal stations. (Sec. 4008) Amends the Communications Act of 1934 to direct the FCC, during FY 1994 through 1998, to use competitive bidding procedures to grant all radio spectrum licenses for which two or more mutually exclusive applications have been filed. Requires a report on such procedures. Provides rural program license procedures. Provides for the State and local tax treatment of radio licenses and permits. (Sec. 4009) Revises the FCC's regulatory authority in the management of mobile communications services. Considers a person engaged in the provision of commercial mobile services to be a common carrier and, therefore, required to establish physical connections with such service as required under the Communications Act. Prohibits a person engaged in private land mobile service from being considered to be a common carrier for such purposes. Prohibits any State or local government from imposing any rate or entry regulation upon any commercial or private land mobile service, but allows a State to regulate other terms and conditions of commercial mobile service, under certain conditions. Provides certain FCC deadlines with repsect to rules, licenses, and permits for personal communications services. Subtitle B: Vessel Tonnage Duties - Amends Federal law to extend through FY 1998 the imposition of tonnage duties on all vessels that enter the United States from a foreign port or place, or that depart a U.S. port or place and return to the same port or place without entering the United States from another port or place. Title V: Committee on Energy and Natural Resources - Subtitle A: Recreation and Commercial Use Fees - Amends the Land and Water Conservation Fund Act of 1965 to: (1) authorize the charging of admission fees for FY 1994 through 1998 at Bureau of Land Management (BLM) national monuments and scenic areas and areas of concentrated public use; (2) strike a provision prohibiting a recreation fee for the use of visitors' centers, picnic tables, or boat ramps; (3) authorize the Secretaries of Agriculture and the Interior to withhold from a special account made up of user fees an amount determined to be equal to the additional fee collection costs for each fiscal year; (4) direct the Secretary of the Interior, for FY 1994 through 1998, to establish and collect fees on commercial tour vehicles entering units of the National Park System in which fees are authorized; and (5) authorize the Secretaries to allow businesses and other organizations to sell and collect fees for the Golden Eagle Passport (an admission passport valid for an entire year). (Sec. 5003) Directs the Secretaries to assess and collect charges for utilization of radio and television communication sites located on Federal lands administered by the Forest Service or BLM. Requires such users to provide the Forest Service or BLM with a list identifying all additional site users and all revenues received from such users. Requires the Secretaries to establish a broad-based advisory group to determine the market value for radio and television communication site users. Requires a report to specified congressional committees. Subtitle B: Hardrock Mining Claim Maintenance Fee - Mandates payment for maintenance fees of $100 per claim by each claimant of an unpatented mining claim, mill or tunnel site on federally-owned lands in order to hold such claims for the assessment year. Declares that such fee is in lieu of assessment work and related filing requirements contained in certain Federal laws. Waives such fees under certain conditions. (Sec. 5102) Mandates the payment of a location fee for every unpatented mining claim, mill or tunnel site located after the date of enactment of this Act and before September 30, 1998. Replaces certain assessment requirements and expenditures with the annual maintenance fee. Subtitle C: Commonwealth for Northern Mariana Islands Agreement - Limits the payments to the Northern Mariana Islands for FY 1994 through 1998 to the amounts and for the purposes set forth in the Agreement of the Special Representatives on Future Financial Assistance of the Northern Mariana Islands of December 1992. Continues funding after 1998 at a specified annual amount. Subtitle D: Mineral Receipts - Amends the Mineral Leasing Act to provide that in calcualting the amount to be paid to States of revenues derived from Federal onshore mineral and geothermal steam leasing receipts, 50 percent of the portion of the appropriation allocable for administration and enforcement shall be deducted from those receipts in approximately equal amounts each month before their division and distribution between the States and the United States. Title VI: Committee on Environment and Public Works - Amends the Omnibus Budget Reconcilitation Act of 1990 to extend from 1995 to 1998 the authority of the Nuclear Regulatory Commission to assess and collect annual charges. (Sec. 6002) Amends the Flood Control Act of 1968 to authorize the Secretary of the Army to charge fees for the use of developed recreation sites and facilities with specified exceptions. Mandates deposit of such fees into a certain account established for the Army Corps of Engineers. Title VII: Finance Committee Reconciliation Provisions Relating to Medicare, Medicaid, and Other Programs - Subtitle A: Medicare - Part I: Provisions Relating to Part A - Amends title XVIII (Medicare) of the Social Security Act (SSA) to: (1) provide for a reduction in payment updates for inpatient hospital services; (2) provide for a reduction in payment for the indirect costs of medical education; (3) extend payments for Medicare-dependent, small rural hospitals; (4) repeal the requirement for a return on equity for proprietary skilled nursing facilities; (5) extend the ten percent reduction in payments for capital-related costs of inpatient hospital services; (6) lower the per diem limits with respect to payments for routine service costs of extended care services; and (7) change the update formula for hospice care payment starting in 1994. (Sec. 7103) Provides for continuation of the other urban payment rate through 1994. Requires the Secretary of Health and Human Services to: (1) permit hospitals that fail to qualify as rural referral centers due to their urban reclassification to decline their reclassification and retain their former status; and (2) make lump-sum retroactive payments to such hospitals. Part II: Provisions Relating to Part B: Subpart A - Physician Services - Amends SSA title XVIII to: (1) reduce the default update for the conversion factor otherwise applicable to surgical and non-surgical services (except primary care services) in 1994; (2) increase the performance standard factor starting in 1994; (3) double the maximum reduction in the default update allowed for 1994 starting in 1995; (4) provide for classification of primary care services as a separate category of services for purposes related to the application of volume performance standards and updates in conversion factors for physicians' services; (5) direct the Secretary to phase-in reductions to the practice expense relative value units for certain services; (6) revise the payment policy for anesthesia care teams; (7) repeal the prohibition on separate billing for the interpretation of electrocardiograms (EKGs); (8) repeal payment reductions for new physicians and practitioners; (9) require adjustments in the relative value units for services provided by physicians and other practitioners in order to ensure budget neutrality; (10) revise the application of the limiting charge policy with respect to claims submitted on a nonassignment basis; (11) add payment and billing rules for services furnished by certain practitioners; (12) set forth requirements for Medicare carriers to provide limiting charge information on the explanation of benefits form furnished to Medicare beneficiaries and screen unassigned claims by service providers before making payment to determine whether the amount billed exceeds the applicable limiting charge; and (13) require the Secretary's report to the Congress on changes in expenditures for physician services to reflect information on charges in excess of the applicable limiting charge. Subpart B: Outpatient Hospital Services and Ambulatory Surgical Services - Amends SSA title XVIII to: (1) extend the ten percent reduction in payments for capital-related costs of outpatient hospital services; (2) extend the reduction in payments for other costs of outpatient hospital services; (3) make changes to payment formulae for outpatient and hospital services. (Sec. 7224) Amends the Omnibus Budget Reconciliation Act of 1990 (OMBRA '90) to reduce payments for intraocular lenses. Subpart C: Durable Medical Equipment - Amends SSA title XVIII to: (1) revise the payment rules for durable medical equipment (DME); (2) provide for the treatment of nebulizers and aspirators and payment for accessories relating to such items; (3) provide a method for determining payment for surgical dressings; and (4) reduce payments for TENS devices. Subpart D: Part B Premium - Amends SSA title XVIII to revise current law establishing the monthly part B premium for Medicare beneficiaries. Subpart E: Other Provisions - Amends SSA title XVIII to: (1) provide for a freeze, then reduction, in updates for certain items and services covered under Medicare part B (Supplementary Medical Insurance), including DMME and ambulatory surgical center services; and (2) lower the cap on payments for clinical diagnostic laboratory tests performed after December 31, 1993. Part III: Provisions Relating to Parts A and B - Amends SSA title XVIII to: (1) revise weighting factors and other criteria used in determining payments for direct graduate medical education costs; (2) include preventive care services as part of the initial residency period; (3) include successor exams in the definition of an FMGEMS examination; (4) modify home health agency cost limits; (5) extend the ban on certain referrals by physicians to cover additional specified health services and include new exceptions as well as modified ones related to its application; and (6) reduce payments for erythropoietin. (Sec. 7303) Amends SSA title XVIII and the Internal Revenue Code (IRC) to make numerous changes with respect to Medicare as secondary payer. Subtitle B: Medicaid Program - Part I: Program Savings Provisions - Subpart A: Repeal of Mandate - Amends SSA title XIX to: (1) repeal the mandate that States cover personal care services under their Medicaid programs for all individuals entitled to nursing facility benefits; and (2) give States the option of covering personal care services furnished in a home or other location. Subpart B: Outpatient Prescription Drugs - Amends SSA title XIX to: (1) allow States, under certain conditions, to establish formularies limiting coverage of prescription drugs under their Medicaid programs; (2) eliminate the prohibition on a State's subjecting covered outpatient drugs to prior authorization during the first six months after the drug is approved by the Food and Drug Admnistration; and (3) make modifications to the Medicaid prescription drug program. Subpart C: Restrictions on Divestiture of Assets and Estate Recovery - Amends SSA title XIX to: (1) revise provisions regarding adjustments and recoveries and transfers of assets; and (2) set forth rules for the treatment of trusts for purposes of determining an individual's eligibility for, and amount of, benefits under a State's Medicaid plan. Subpart D: Improvement in Identification and Collection of Third Party Payments - Amends SSA title XIX to: (1) address the liability of third parties to pay for care and services under Medicaid; and (2) require States to have in effect certain specified laws relating to medical child support. (Sec. 7433) Amends IRC and SSA title XIX to provide for collection of payment obligations relating to medical assistance from State and Federal tax refunds. Subpart E: Assuring Proper Payments to Disproportionate Share Hospitals - Amends SSA title XIX to make changes with regard to payments for disproportionate share hospitals. Subpart F: Anti-Fraud and Abuse Provisions - Amends SSA title XIX to prohibit payment with respect to any amount expended for an item or service for which payment would be denied under the Medicare ban on certain physician referrals if the item or service were furnished to an individual entitled to benefits under Medicare. Part II: Other Medicaid Provisions - Amends OMBRA '90 to revise: (1) the limits on expenditures and funding for demonstration projects to study the effect of allowing States to extend Medicaid coverage to certain low-income families not otherwise qualified to receive Medicaid benefits; and (2) project reporting requirements. Subtitle C: Income Security Programs - Amends SSA title IV part A (Aid to Families with Dependent Children) (AFDC) to make changes with regard to Federal matching of a State's AFDC administrative expenditures. Amends SSA titles I (Old Age Assistance), X (Aid to the Blind), XIV (Aid to the Permanently and Totally Disabled), and XVI (Supplemental Security Income) to revise the formula for determining Federal payments to the States for expenses incurred in administering their State plans under such SSA titles. Amends SSA titles XI to change the requirements for attesting to citizenship status. (Sec. 7602) Amends SSA title IV part D (Child Support and Establishment of Paternity) to: (1) modify performance standards for State paternity etsablishment programs; and (2) modify existing, and require certain additional, procedures under State law with respect to child support enforcement. (Sec. 7603) Amends SSA title XVI (SSI) and other Federal law to: (1) require the Social Security Administration to charge States fees for the Federal cost of administering State supplemental SSI payments; and (2) require the Secretary to charge fees for additional services requested by the State that are beyond the level customarily provided in administering a State's supplemental SSI payments. Subtitle D: Miscellaneous Provisions - Part I: Trade Provisions - Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 to extend authority for levying customs user fees. (Sec. 7702) Amends the Trade Act of 1974 to provide for an extension of, and authorization of appropriations for, the trade adjustment assistance program. Part II: Improved Access to Childhood Immunizations - Amends SSA title XIX to direct the Secretary to promulgate a list of vaccines that provide immunization against naturally occurring infectious diseases and are recommended for universal use in children. Provides for immunization outreach through the EPSDT (Early and Periodic Screening, Diagnostic, and Treatment Services) Program. Requires Medicaid managed care plans to comply with specified requirements relating to EPSDT. Allows State plans to make payments directly to the manufacturer of the vaccine under a voluntary replacement program. Requires the Secretary to provide for demonstration projects designed to improve the rate and timeliness of immunization against childhood diseases in the case of any Medicaid-eligible child up to age two who is part of a family eligible for AFDC. (Sec. 7803) Amends SSA to add a new title XXI entitled "Central Bulk Purchasing Program For Pediatric Vaccines" under which the Secretary shall provide for the purchase and delivery on behalf of the applicant State of such quantities of pediatric vaccines as may be necessary for the immunization of each eligible child in the State. Part III: Disclosure Provisions - Amends the Internal Revenue Code to extend the authority to disclose return information for the administration of certain veterans programs. (Sec. 7902) Authorizes the disclosure of such information: (1) in the administration of repayments of certain student loans; and (2) for income verification under certain housing assistance programs. (Sec. 7904) Amends title XI of the Social Security Act to provide for the establishment of a Third Party Liability Clearinghouse to identify third parties responsible for payment for health care items and services furnished to beneficiaries of Medicare and Medicaid. Authorizes the disclosure of certain taxpayer return information for purposes of identifying health insurance coverage of certain individuals and spouses. Requires employers to report whether a group health plan is available to an employee on wage statements. Part IV: Other Provisions - Expands the 45-day interest-free period for refunding tax overpayments to all returns, as well as to amended returns and claims for refunds. Provides that if interest is not refunded within 45 days after the taxpayer files an amended return or claim for refund, interest will be paid only for periods after the date on which the return or claim is filed. (Sec. 7951) Requires the establishment of a program requiring the payment of user fees for the processing of applications for certificates of alcohol label approval and exemption, formula reviews, and statements of process (including laboratory tests and analyses). (Sec. 7952) Removes authority to use the Harbor Maintenance Trust Fund for administrative expenses of certain customs fee collections. (Sec. 7953) Increases the amount that individuals may designate to the Presidential Election Campaign Fund on their tax returns. (Sec. 7954) Increases the public debt limit and repeals the temporary limit on such increases. Title VIII: Revenue Provisions - Revenue Reconciliation Act of 1993 - Subtitle A: Training and Investment Incentives - Extends until June 30, 1994 the tax exclusion for employer-provided educational assistance and the targeted jobs credit. (Sec. 8111) Suspends the credit for increasing research activities from July 1, 1992 through June 30, 1993, and any period after June 30, 1994. Modifies the fixed base percentage of such credit for startup companies for taxable years after 1993. (Sec. 8113) Expresses the sense of the Senate that the credit for increasing research activities be extended permanently. (Sec. 8115) Eliminates the depreciation adjustment for computing adjusted current earnings for property placed in service after December 31, 1993. (Sec. 8119) Increases the dollar limitation on the election to expense certain depreciable small business assets. (Sec. 8121) Extends until June 30, 1994, the authority to issue qualified small issue bonds to finance manufacturing facilities and farm property. (Sec. 8131) Repeals certain interaction rules of the earned income credit with respect to the medical expense deduction, the deduction for health insurance, and the dependent care credit. Revises credit and phaseout percentages for 1994. (Sec. 8141) Extends the authority to issue qualified mortgage bonds and qualified mortgage credit certificates until June 30, 1994. Makes permanent the low-income housing credit. (Sec. 8141A) Expresses the sense of the Senate that Congress should adopt a permanent extension of the mortgage revenue bond program. (Sec. 8143) Provides for the treatment of rental real estate activities under the limitations on losses from passive activities. (Sec. 8144) Modifies exceptions to the exclusion of real property acquired by a qualified organization from the meaning of acquisition indebtedness. Makes certain exceptions inapplicable to sales out of foreclosure by a financial institution. (Sec. 8145) Repeals the special rule for publicly traded partnerships with respect to the treatment of unrealted business taxable income. (Sec. 8146) Permits a tax-exempt title-holding company to receive unrelated business taxable income if the unrelated income is incidentally derived from the holding of real property. (Sec. 8147) Excludes from unrelated business taxable income: (1) gains from the sale, exchange or other disposition of real property acquired from financial institutions that are in conservatorship or receivership; and (2) loan commitment fees and certain option premiums. Provides for the tax treatment of pension fund investments in real estate investment trusts. (Sec. 8151) Increases the depreciation recovery period for nonresidential real property. (Sec. 8161) Repeals the luxury excise tax on boats, aircraft, jewelry, and furs. Modifies the luxury excise tax on automobiles to index the threshold for inflation occurring after 1990 and make such tax applicable to the first retail sale. (Sec. 8162) Exempts from the luxury excise tax parts for accessories installed for use of passenger vehicles by disabled individuals. (Sec. 8163) Extends the current diesel fuel excise tax to diesel fuel used by noncommercial motorboats. Retains such taxes in the General Fund of the Treasury. (Sec. 8171) Repeals the tax preference for the appreciated property charitable deduction. Disallows an adjustment related to the earnings and profits effects of any charitable contribution from being made in computing adjusted current earnings. (Sec. 8172) Establishes substantiation requirements for charitable contributions of $250 or more. (Sec. 8173) Sets forth disclosure requirements for an organization that receives a quid pro quo contribution (payment made partly as a contribution and partly in consideration for goods or services provided to the payor by the donee organization). Imposes a penalty for failure to make such disclosure. (Sec. 8174) Amends the Railroad Retirement Solvency Act of 1983 to make permanent the treatment of certain railroad retirement benefits as received under employer plans. (Sec. 8175) Provides for the temporary extension of the deduction of health insurance costs of self-employed individuals. (Sec. 8181) Establishes an Indian reservation credit as a tax credit for investment in qualified Indian reservation property. Declares that such credit applies only in the event that the Indian unemployment rate on the applicable reservation exceeds 300 percent of the national average unemployment rate at any time during the taxable year or in the immediately preceding taxable year. (Sec. 8182) Allows businesses an employment credit for the qualified wages and qualified employee health insurance costs paid or incurred during a taxable year. Subtitle B: Revenue Increases - Lowers the tax rates for certain taxpayers and increases the tax rate for certain higher incomes. Imposes a surtax on certain higher incomes. (Sec. 8203) Increases the tentative minimum tax for taxpayers other than corporations. (Sec. 8204) Makes permanent the overall limitation on itemized deductions and the phaseout of personal exemptions for high-income taxpayers. (Sec. 8206) Sets forth provisions to prevent the conversion of ordinary income to capital gain in certain financial transactions. Repeals certain exceptions to market discount rules. Provides for the treatment of purchases of stripped preferred stock after April 30, 1993. Revises the methods of: (1) computing the limitation on the deductibility of investment interest; and (2) determining substantial appreciation of partnership inventory items. (Sec. 8207) Repeals the limitation on the amount of wages subject to the health insurance employment tax. (Sec. 8208) Increases and makes permanent the highest estate and gift tax rate. (Sec. 8209) Reduces the deduction for business meals and entertainment expenses. Expresses the sense of the Senate that the deductibility of business meals and entertainment expenses should be reduced or eliminated. (Sec. 8210) Disallows a tax deduction for social club membership dues, except for employee recreational expenses. (Sec. 8211) Disallows a deduction as a trade or business expense remuneration to certain employees in excess of specified amounts. (Sec. 8212) Reduces the compensation taken into account in determining contributions and benefits under qualified retirement plans. (Sec. 8213) Removes qualified residence sales, purchases, or leases and meals from the deduction for moving expenses. Places a dollar limitation on the deduction for moving expenses. (Sec. 8214) Revises the limitation on using the preceding year's tax to calculate an individual's estimated tax payments. (Sec. 8215) Increases the amount of social security and tier 1 railroad retirement benefits to be included in the gross income of certain taxpayers. (Sec. 8221) Increases the tax rate for corporate income in excess of $10 million and the tax rate on personal service corporations. (Sec. 8222) Denies a tax deduction for lobbying expenses. Subjects lobbying organizations to special reporting requirements. (Sec. 8223) Requires any security which is inventory in the hands of the dealer to be included in inventory at its fair market value. Requires any dealer in securities that holds any security which is not in inventory at the close of any taxable year to: (1) recognize gain or loss as if the security were sold on the last business day of the taxable year; and (2) take into account any such gain or loss for such year (the mark-to-market requirement). (Sec. 8224) Requires taking into account: (1) certain Federal Savings and Loan Insurance Corporation (FSLIC) assistance as compensation for loss; and (2) any FSLIC assistance for any debt for any debt for determining the whether such debt is worthless and in determining the amount of any addition to a reserve for bad debts arising from such worthlessness or partial worthlessness. (Sec. 8225) Increases the required annual payment for corporations that fail to pay estimated income tax. Modifies the periods for applying such annualization. (Sec. 8226) Repeals the stock for debt exception in determining income from discharge of indebtedness. (Sec. 8227) Limits the Puerto Rico and possession tax credit to 40 percent of the possession corporation's qualified possession wages by 1998 and thereafter. (Sec. 8228) Modifies the limitation on corporate deductions for interest paid to related persons to take into account disqualified guarantees of indebtedness and the imposition of a gross basis tax. (Sec. 8231) Requires U.S. shareholders of controlled foreign corporations to include in gross income a pro rata share of the corporations excess passive assets. Sets forth rules for determining such amounts. Modifies the rule on taxation of investment in United State property and takes into account excessive passive assets. (Sec. 8233) Excepts from foreign personal holding income dividends attributable to earnings and profits of the distributing corporation accumulated during any period during which the person receiving such dividend did not hold such stock. Requires the establishment of an excess limitation account by taxpayers who receive foreign tax credits in a year they receive previously taxed earnings and profits. (Sec. 8234) Reduces the amount allowed as allocation and apportionment of research and experimental expenditures from sources within the United States. (Sec. 8235) Excludes passive dividends or interest income from foreign oil and gas income. (Sec. 8236) Modifies accuracy-related penalties for tax underpayments. (Sec. 8237) Denies the inclusion of certain contingent interest in the exemption for portfolio interest for nonresident aliens. (Sec. 8238) Authorizes the Secretary of the Treasury to prescribe regulations recharacterizing any multiple-party financing transaction as a transaction directly among any two or more such parties where appropriate to prevent any tax avoidance. (Sec. 8239) Provides that export property eligible for certain tax incentives does not include any unprocessed softwood timber for purposes of: (1) taxationof foreign sales corporations (FSCs); and (2) taxation of domestic international sales corporations (DISCs). Requires any income from the sale of such unprocessed timber which was cut from an area in the United States to be sourced in the United States. Repeals the deferral for income of the controlled foreign corporation from sales or milling (outside the United States) of unprocessed softwood timber to the extent that any controlled foreign corporation is owned by ten percent or more U.S. shareholders. (Sec. 8241) Increases the excise tax on gasoline, diesel fuel, aviation fuel, and other transportation fuels. (Sec. 8242) Imposes an excise tax on fuel (separate from the gasoline tax and the tax on aviation). Exempts from such tax diesel fuel: (1) used by trains and intercity, local, or school buses; and (2) which is dyed or marked in accordance in regulations prescribed by the Secretary of the Treasury. Provides that the Airport and Airway Trust Fund financing rate does not apply to aviation fuel sold by a producer or importer for use by the purchaser in a nontaxable use. Imposes a civil penalty on persons who use reduced-rate fuel for a taxable use. (Sec. 8243) Imposes a floor stocks tax on any person holding diesel fuel April 1, 1994. (Increases the tax on gasoline and diesel fuels for purposes of the Highway Trust Fund financing rate. Increases the amount to be transferred to the Mass Transit Account from such Fund. (Sec. 8251) Modifies provisions concerning substantial understatement and return-preparer penalties to allow reasonable cause exceptions. (Sec. 8252) Requires certain financial entities (including the Federal Deposit Insurance Corporation, the Resolution Trust Corporation, and the National Credit Union Administration, and their successors or subunits) to file information returns regarding discharges of indebtedness of $600 or more. (Sec. 8261) Allows an amortization deduction with respect to certain intangible property, including goodwill, that is acquired and held by a taxpayer in connection with the conduct of a trade or business or an activity engaged in for the production of income. (Sec. 8271) Denies the business travel expense deduction for spouses, dependents, or others. (Sec. 8272) Increases the withholding rate for supplemental wage payments. (Sec. 8273) Makes permanent the excise tax on certain vaccines. Title IX: Committee on Foreign Relations - (Sec. 9001) Delays cost-of-living adjustments in Foreign Service retirement benefits during FY 1994 through 1996. (Sec. 9002) Eliminates the lump sum retirement option for certain Foreign Service employees. Title X: Committee on Governmental Affairs - Subtitle A: Civil Service - (Sec. 1001) Delay cost-of-living adjustments in Federal employee retirement benefits during FY 1994 through 1996. (Sec. 1002) Eliminates permanently the lump sum retirement option for certain Federal employees. (Sec. 1003) Amends Federal law to make changes regarding District of Columbia government contributions for specified periods for certain employee and annuitant health benefits. Subtitle B: Postal Service - Directs the United States Postal Service to make a specified additional payment into the Civil Service Retirement and Disability Fund and the Employee Health adjustments and increases in health benefits costs. Subtitle C: Miscellaneous - Makes changes under the Civil Service and Federal Employees Retirement Systems regarding survivor annuities. Title XI: Judiciary - Amends the Omnibus Budget Reconciliation Act of 1990 to extend through FY 1998 the surcharge fees for Patent and Trademark Office users. Title XII: Committee on Labor and Human Resources - Subtitle A: Student Loan Provisions - Student Loan Reform Act of 1993 - Amends the Higher Education Act of 1965 (HEA) to replace the Federal Family Education Loan Program, under which loans made by private lenders are guaranteed by the Government, with a Federal Direct Student Loan Program, over a four-year transition period. Chapter 1: Federal Direct Student Loan Program - Amends HEA to change the Federal Direct Loan Demonstration Program to the Federal Direct Student Loan Program (FDSL). (Sec. 12011) Sets forth program authority for making necessary sums available to make FDSL loans to all eligible students (and parents) at participating higher education institutions selected by the Secretary of Education (Secretary), for the period beginning July 1, 1994. Requires such loans to be made by participating institutions that also have agreements with the Secretary to originate loans, or by alternative originators designated by the Secretary. Directs the Secretary to provide funds for such student and parent loans either directly to a participating institution that also has an origination agreement or to a designated alternative originator, on the basis of need and eligibility of students and parents at each participating institution. Requires the Secretary to pay fees to assist in meeting costs of loan origination to participating institutions or alternative originators. Declares that no institution shall have a right to participate in FDSL programs. Provides for phase-in of the program, and application of the requirements of the Cash Management Improvement Act of 1990 on a transition schedule. Sets forth selection criteria for an institution's participation in the FDSL program and in origination agreements. Allows consortia of eligible participating institutions to apply to originate FDSL loans as consortia. Sets forth FDSL program participation and origination agreement requirements for institutions. Sets forth terms and conditions for FDSL loans, including certain parallels with Stafford, supplemental, parent, and unsubsidized Stafford loans under the FFEL program. Sets interest rates according to different formulas for loans made before rather than on or after July 1, 1997. Sets minimum and maximum loan fees to be charged to borrowers. Provides for standard, extended, graduated, and income contingent repayment plan options. Sets forth deferment and forbearance possibilities (including national service). Sets forth provisions for consolidation, borrower defenses, optically imaged records, and nondischargeability in bankruptcy. Authorizes the Secretary to award contracts under the FDSL program for: (1) alternative origination of loans; (2) servicing and collection of loans; (3) data systems for records maintenance; and (4) services to assist in orderly transition from FFEL to FDSL programs. Authorizes the Secretary to use funds for research on, or demonstration or evaluation of, any FDSL program aspects, including flexible repayment plans. Provides funds for specified administrative expenses of the FDSL program and the transition from the FFEL program, including certain transition expenses of guaranty agencies. Establishes a bipartisan National Student Loan Reform Commission to study the advisability of replacing the FFEL program with direct lending. Authorizes appropriations. Chapter 2: Student Loan Savings - (Sec. 12022) Revises interest rates for student loans after July 1, 1994. (Sec. 12023) Reduces student loan origination fees paid by students. Requires lenders to pay fees. (Sec. 12024) Requires the Student Loan Marketing Association (Sallie Mae) to pay an offset fee to the Secretary. (Sec. 12025) Reduces the amount of the tax exemption granted to holders of certain student loans. (Sec. 12026) Reduces the interest rate for consolidation loans. Requires holders of consolidation loans to pay a rebate fee to the Secretary. (Sec. 12027) Reduces certain maximum interest premiums and eliminates certain reinsurance fees. (Sec. 12028) Requires the transferee to pay the Secretary a loan transfer fee. (Sec. 12030) Establishes a $10,000 annual limit on PLUS loans, still subject to the limitation based on need. Requires multiple disbursement. Chapter 3: Conforming Amendments - Subchapter A: Conforming Amendments to the Higher Education Act of 1965 - Amends HEA to provide for access to FFEL program student and parent loans during the transition to the FDSL program. Provides for advances to guaranty agencies for lender-of-last-resort services. Requires Sallie Mae or its designated agent to begin making FFEL loans as lender-of-last-resort, subject to certain limitations, upon the Secretary's request, and to cease such lending when the triggering conditions have ceased. (Sec. 12043) Modifies terms of loans under the FFEL program. Authorizes requiring a defaulted borrower to make income contingent repayments. Subchapter B: Amendments to Other Laws - Amends the Internal Revenue Code to add or revise provisions relating to disclosure of tax return information with respect to income contingent repayment of student loans, individuals who owe on overpayment of Federal Pell Grants, and collection of payments on Federal Direct Student Loans. Chapter 4: Cost Sharing by States - Amends HEA to require any State in which there are higher education institutions which cohort default rates exceeding 20 percent to pay the Secretary specified portions of costs related to such loan defaults. Allows States to charge institutions fees based on their cohort default rate and the State's risk of loss. Chapter 5: General Effective Date - Sets forth the effective dates of subtitle A. Subtitle B: Public Health Service Act Provisions - Amends the Public Health Service Act (PHSA) to create a new title establishing the Health Coverage Clearinghouse to identify third parties that may be liable for payment for health care items and services furnished by a covered health program (defined as certain entities under the PHSA, a non-Federal entity under the Indian Self-Determination Act, or any other federally funded program providing payments for medical services that may be covered under a private health insurance policy). Requires: (1) the Secretary of the Treasury to furnish tax information to the Clearinghouse on the identity and employer of the spouse or parents; and (2) employers to furnish information on group health plan coverage of the individual, spouse, or parents. Requires the Clearinghouse to maintain a data bank containing such information. Authorizes disclosure of any information in the data bank to: (1) the Secretary, administrators of covered health programs (CHPs), employers, insurers; and (2) Federal and State law enforcement officials in connection with proceedings relating to a CHP. Mandates service fees to cover Clearinghouse costs. Amends the Employee Retirement Income Security Act of 1974 (ERISA) to require the administrator of each employee benefit plan to comply with the amendments made by these provisions. (Sec. 12102) Mandates a study on referral of a patient by a health care provider to an entity in which the provider has a financial interst or from which the provider receives a financial benefit for the referral. (Sec. 12103) Delays, during specified fiscal years, cost-of-living increases for National Health Service Corps retiree annuitants. (Sec. 12104) Allows a members of the Corps who is covered by provisions of Federal law relating to retirement or the Federal Employees' Retirement System and has a critical medical condition to elect annuity benefits under specified provisions. (Sec. 12105) Amends the PHSA to allow services to individuals who are not patients of such an entity to be covered in certain circumstances. Allows malpractice coverage in certain circumstances for officers, employees, and contractors of entities that are migrant or community health centers or that provide health services for the homeless or for residents of public housing when they provide services to individuals who are not patients of the entities. Subtitle C: Improved Immunization Delivery and Monitoring - Comprehensive Child Immunization Act of 1993 - Amends the Public Health Service Act to mandate establishment of a list of the vaccines that the Secretary of Health and Human Services recommends for administration to all children and a recommended administration schedule. Mandates the list and schedule subordinate to State law. Mandates allotments to States. Provides for the establishment of State registries to monitor the immunization outreach and education efforts, including a National Immunization Public Awareness Campaign and incorporation of status of all children. Requires States to monitor and enforce compliance with these provisions by health care providers. Authorizes appropriations. Establishes a national immunization surveillance program to assess the effects of these provisions, provide technical assistance to States, and receive aggregate epidemiologic data collected by States. Authorizes appropriations. Directs the Secretary of Health and Human Services to provide for the distribution, without charge, of pediatric vaccines purchased by the Secretary to health care providers who are: (1) members of a uniformed service; (2) U.S. officers or employees; (3) federally qualified health centers; (4) migrant or community health centers; (5) entities providing health services for the homeless or for residents of public housing; or (6) public or nonprofit entities receiving funds under provisions of the Social Security Act relating to special projects of regional and national significance. Prohibits a provider receiving the vaccine from imposing a charge for the vaccine but allows a charge for the actual costs of the administration of the vaccine. Mandates activities to improve Federal, State, and local vaccine delivery systems and immunization status assessments and referral in the application process for various types of Federal assistance. Authorizes grants to States to develop, revise, and implement immunization improvement plans. Requires States to establish child immunization rate goals. Authorizes appropriations. Mandates: (1) a biennial report on the costs, efficiency, and effectiveness of procedures established to deliver vaccine to health care providers; and (2) a report by the National Academy of Sciences on the role of the National Vaccine Program established under this title in achieving progress toward the established immunization goals for the year 2000. (Sec. 12203) Requires that the Vaccine Injury Table of the National Vaccine Injury Compensation Program include any vaccine on the list established under this subtitle. Allows a special master to award reasonable attorneys' fees whether or not an election has been made to file a civil action regarding a vaccine injury compensation petition. Requires that compensation under the Program be used as determined by the special master to be in the best interests of the petitioner, (Current law requires that the compensation be used, with the consent of the petitioner. as determined by the special master to be in the best interests of the petitioner.) Sets time limits regarding applications for attorneys' fees and costs. Authorizes appropriations for payment of compensation under the Program regarding vaccines administered before the effective date of the Program. Revises requirements regarding: (1) time limits on actions when the Table is revised; and (2) extensions of time limits for decisions. Mandates an annual report on amounts collected under provisions regarding subrogation of petitioners' rights. Requires the Advisory Commission on Childhood Vaccines to monitor the balance of the Vaccine Injury Trust Fund and recommend changes in the tax per dose. Revises requirements regarding vaccine information materials. Authorizes appropriations from the Trust Fund for administering the National Vaccine Program. (Sec. 12204) Removes provisions authorizing grants for research on the prevention and control of diseases through vaccine and related demonstration projects, public information programs, and health professionals training and clinical skills improvement. (Sec. 12205) Mandates: (1) an annual report by States estimating the percentage of fully immunized two year old residents; and (2) payments to States based on those percentages. Subtitle D: ERISA Amendments - Chapter 1: Group Health Amendments - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to coordinate ERISA preemption rules with Medicaid provisions for liability of third parties. (Sec. 12302) Prohibits a group health plan from reducing its coverage of the costs of pediatric vaccines below that provided as of May 1, 1993. Chapter 3 (sic): Public Health Service Act - Amends the Public Health Service Act to prohibit a health insurance policy in effect prior to May 1, 1993, from reducing its coverage of the costs of pediatric vaccines below that provided on the enactment date of this provision. Title XIII: - Veterans' Programs - Extends permanently (currently ends September 30, 1997) the $90 monthly pension limitation for veterans having neither spouse nor child and being furnished domiciliary care by the Department of Veterans Affairs. States that the FY 1994 cost of living increases in veterans' disability compensation and dependency and indemnity compensation shall be no more than the percentage increases under title II (Old Age, Survivors and Disability Insurance) of the Social Security Act. Requires an increased reduction in the monthly basic pay of active duty and reserve personnel entering into service after FY 1993 for participation in the Montgomery GI Bill educational assistance program. Provides similar increases for those enrolled in such program before either voluntary or involuntary separation from the armed forces. Extends permanently (currently terminated as of December 31, 1992) certain procedures applicable to liquidation sales on defaulted home loans to veterans which were guaranteed by the Department. Increases the home loan fees charged to such veterans for such guaranteed loans. Extends permanently: (1) the authority of the UnitedStates to recover from third party insurers the cost of certain care and services provided to veterans through the Department; (2) a required minimum copayment for medication received by certain veterans on an outpatient basis; and (3) the authority of the Secretary of Veterans Affairs to obtain, and the Secretary of the Treasury to provide, certain financial information of veterans for income verification purposes. XIV: Enforcement Procedures - Amends the Congressional Budget Act of 1974 to prescribe enforcement mechanisms for discretionary spending limits for FY 1996 through 1998. Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to extend pay-as-you-go provisions through FY 1998. Title XV: Miscellaneous Provisions - Expresses the sense of the Senate on the adoption of Federal enterprise zone legislation. American Citizens Annual Report Act - Authorizes appropriations for FY 1994 through 1998 to the Secretary of the Treasury and the Director of the Office of Managementand Budget for the distribution to all taxpayers of an annual fiscal report.

TABLE OF CONTENTS: Title I: Committee on Agriculture Title II: Committee on Armed Services Title III: Committee on Banking, Finance and Urban Affairs Title IV: Education and Labor Title V: Committee on Energy and Commerce Title VI: Committee on Foreign Affairs Title VII: Committee on the Judiciary Title VIII: Committee on Merchant Marine and Fisheries Title IX: Committee on Natural Resources Title X: Committee on Post Office and Civil Service Title XI: Committee on Public Works and Transportation Title XII: Committee on Veterans Affairs Title XIII: Committee on Ways and Means-Savings Title XIV: Revenue Provisions Title I: Committee on Agriculture - Agricultural Reconciliation Act of 1993 - Subtitle A: Commodity Programs - Amends the Agricultural Act of 1949 to reduce payment acres for wheat, feed grains, upland cotton, and rice. (Sec. 1101) Extends specified loan, payment, and acreage reduction programs for wheat, feed grains, upland cotton, rice, milk and dairy products, tobacco, sugar, oilseeds, peanuts, honey, and wool and mohair. Sets forth maximum purchase prices for butter and nonfat dry milk. Increases marketing assessments for tobacco and sugar. Establishes an additional marketing assessment for peanuts. (Sec. 1109) Amends the Harmonized Tariff Schedule of the United States to provide temporary additional customs duties on peanut butter and peanut paste. Subjects peanut butter to import quotas. (Sec. 1110) Amends the Agricultural Act of 1949 to reduce the support rate and annual payments for honey. Eliminates marketing assessments. (Sec. 1111) Reduces annual payments for wool and mohair. Eliminates marketing assessments. Subtitle B: Restructuring of Loan Programs - Amends the Rural Electrification Act of 1936 to restructure current Rural Electrification Administration (REA) electric and telephone loan programs, including creation of categories of hardship loans and municipal (electric) loans. Authorizes appropriations. (Sec. 1202) Transfers REA authority to the Department of Agriculture's Rural Development Administration. Subtitle C: Food Stamp Program - Mickey Leland Childhood Hunger Relief Act - Chapter 1: Ensuring Adequate Food Assistance - Amends the Food Stamp Act of 1977 to increase the basic food stamp program (program) benefit to 104 percent of the thrifty food plan. (Sec. 1312) Increases the age for students whose income is excluded from consideration as program income. (Sec. 1313) Removes (with an interim increase) the excess shelter cap. (Sec. 1314) Eliminates food stamp reductions for certain reapplying households. (Sec. 1315) Excludes third party payments for transitional housing for the homeless from consideration as program income. (Sec. 1318) Increases funding for the nutrition assistance program in Puerto Rico. (Sec. 1316) Excludes general assistance vendor payments from consideration as program income. Chapter 2: Promoting Self Sufficiency - Excludes education assistance and certain child support from consideration as program income. (Sec. 1324) Increases dependent care deductions and participant and State agency reimbursements in connection with employment and training activities. (Sec. 1325) Increases annually the fair market value limits of vehicles that program recipients may own. (Sec. 1326) Excludes from financial resources the value of a household vehicle used to carry heating fuel or water for home use. (Sec. 1327) Authorizes resource accumulation demonstration projects. Chapter 3: Simplifying the Provision of Food Assistance - Permits related adults living in the same household to apply for separate program benefits. (Sec. 1332) Makes children living with parents who are partcipating in drug or alcohol treatment programs eligible for food stamps. (Sec. 1333) Permits a participating family made up of, or including, an elderly or disabled member to own $3,000 in allowable financial resources. (Sec. 1334) Repeals provisions authorizing benefit reductions due to funding. Chapter 4: Improving Program Integrity - Expands: (1) the permitted use and disclosure of information provided by retail and wholesale food concerns; and (2) claims collections alternatives. (Sec. 1343) Authorizes demonstration projects aimed at coupon trafficking. Chapter 5: Improving Food Stamp Program Management - Excludes from categorical eligibility any household disqualified from participation because of workfare noncompliance. (Sec. 1353) Disqualifies program participants for trading food stamp coupons for controlled substances or for firearms, ammunition, or explosives. (Sec. 1356) Modifies the program's quality control system. Requires an error measurement study. Chapter 6: Uniform Reimbursement Rates - Revises State reimbursement rates. Chapter 7: Implementation and Effective Dates - Sets forth implementation and effective dates. Subtitle D: Miscellaneous Provisions - Amends the Agricultural Trade Act of 1978 to extend and reduce expenditure levels for the market promotion program. (Sec. 1402) Authorizes the Secretary of Agriculture (Secretary) to improve admission and recreation fees at specified public use areas. (Sec. 1403) Requires reduction of Department of Agriculture expenditures through personnel and office consolidations. (Sec. 1404) Amends the Food Security Act of 1985 to: (1) reduce the conservation reserve program acreage requirement; and (2) revise and make mandatory wetlands reserve program acreage requirements. (Sec. 1405) Amends the Federal Crop Insurance Act to direct the Federal Crop Insurance Corporation to make available four levels of commodity insurance based upon percentage of loss in yield. Title II: Committee on Armed Services - Directs the Secretary of Defense to provide a limited increase in the military retired pay of any former military personnel who became a member of the armed forces before August 1, 1986. (Sec. 2002) Waives the automatic FY 1994 increase in the rates of basic pay, basic allowance for quarters, and basic subsistence allowance. Provides that if the General Schedule pay rates for Federal employees is increased during any of FY 1995 through 1998, then military pay rates shall be increased. Title III: Committee on Banking, Finance and Urban Affairs - Amends the Federal Deposit Insurance Act to prescribe an order of priority for the distribution of amounts realized from the resolution of any insured depository institution. Requires distributions in connection with certain claims to be accompanied by an accounting report. (Sec. 3002) Amends the Federal Reserve Act to mandate that for FY 1994 through FY 1998 specified percentages of the surplus fund of any Federal reserve bank be transferred to the Treasury. Prohibits a Federal reserve bank from replenishing its surplus fund by the amount of such transfer. (Sec. 3003) Amends the Stewart B. McKinney Homeless Assistance Amendments Act of 1988 to: (1) require that certain income disclosure consent forms be submitted for verification of eligibility for benefits; and (2) amend applicant, participant, and public housing agency protections. (Sec. 3004) Amends the National Housing Act to direct the Government National Mortgage Association (GNMA) to: (1) charge fees in connection with its multiclass securities guarantee program; (2) assure that a portion of program benefits accrue to mortgagors who execute eligible mortgages; and (3) summarize program activities to the Congress. (Sec. 3005) Directs the Secretary of Housing and Urban Development to increase the rate at which the Secretary earns the single premium payment collected at the time of insurance of a mortgage that is an obligation of the Mutual Mortgage Insurance Fund. Title IV: Education and Labor - Subtitle A: Federal Direct Loan Program - Student Loan Reform Act of 1993 - Amends the Higher Education Act of 1965 (HEA) to replace the Federal Family Education Loan Program, under which loans made by private lenders are guaranteed by the Government, with a Federal Direct Student Loan Program. Chapter 1: Amendments to Part D of Title IV of the Higher Education Act of 1965 - Amends HEA to change the Federal Direct Loan Demonstration Program to the Federal Direct Student Loan Program (FDSL). (Sec. 4002) Sets forth program authority for making sums available for FDSL loans to all eligible students (and parents). Directs the Secretary of Education to provide funds for such student and parent loans on the basis of need and eligibility of students and parents at each participating institution. Declares that no institution shall have a right to participate in FDSL programs. Provides for application of the requirements of the Cash Management Improvement Act of 1990 on a transition schedule. Sets forth selection criteria for an institution's participation in the FDSL program and in origination agreements. Allows consortia to apply to originate FDSL loans. Sets forth terms and conditions for FDSL loans, including certain parallels with Stafford, supplemental, parent, and unsubsidized Stafford loans under the FFEL program. Sets interest rates. Sets minimum and maximum loan fees. Provides for standard, extended, graduated, and income contingent (EXCEL account) repayment plan options. Sets forth deferment and forbearance possibilities (including national service). Authorizes the Secretary to award contracts under the FDSL program for: (1) alternative origination of loans; (2) servicing and collection of loans; (3) data systems for records maintenance; and (4) services to assist in orderly transition from FFEL to FDSL programs. Authorizes the use of funds for research on FDSL program aspects, including flexible repayment plans. Chapter 2: Conforming Amendments - Amends HEA with respect to FFEL program student and parent loans during the transition to the FDSL program. (Sec. 4021) Provides for advances to guaranty agencies for lender-of-last-resort services. Requires the Student Loan Marketing Association (Sallie Mae) to begin making FFEL loans as lender-of-last-resort and to cease such lending when the triggering conditions have ceased. (Sec. 4028) Requires a study of alternatives for Sallie Mae during and after the transition to FDSL, including its own transition from a Government-sponsored enterprise to a private corporation. (Sec. 4030) Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to provide that any reductions in the FDSL program required by a sequestration order shall be achieved only through a specified increase in the loan fee. Chapter 3: Effective Dates; Study - Sets forth effective dates for amendments made by this Act. (Sec. 4032) Directs the Secretary to report to the Congress on the feasibility of Internal Revenue Service (IRS) collection of student loan repayments. (Sec. 4033) Expresses the preference of the House Committee on Education and Labor for an IRS collection mechanism. Subtitle B: Cost Sharing by States - Amends HEA to require any State in which there are higher education institutions with cohort default rates exceeding 20 percent to pay portions of costs related to such loan defaults. Allows States to charge institutions fees based on their cohort default rate and the State's risk of loss. Subtitle C: ERISA Amendments Relating to Group Health Plans - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to coordinate ERISA preemption rules with Medicaid provisions for liability of third parties. (Sec. 4202) Prohibits a group health plan from reducing its coverage of the costs of pediatric vaccines below that provided as of May 1, 1993. (Sec. 4203) Sets forth rules whereby: (1) ERISA preemption of State laws shall be inapplicable to certain State laws (of Hawaii, Maryland, Minnesota, and New York); or (2) the Secretary of Labor can assist such States in effectuating the policies of certain provisions superseded by ERISA. Title V: Committee on Energy and Commerce - Subtitle A: Medicare Program - Chapter 1: Provisions Relating to Part B - Subchapter A: Physicians' Services - Amends title XVIII (Medicare) of the Social Security Act (SSA) to, among other things: (1) reduce the default update for the conversion factor otherwise applicable to surgical and non-surgical services (except primary care services) in 1994; (2) increase the performance standard factor; (3) provide for classification of primary care services as a separate category of services with respect to volume performance standards and updates in conversion factors for physicians' services; (4) phase-in reductions to the practice expense relative value units; (5) revise the payment policy for anesthesia care teams; (6) repeal the prohibition on separate billing for the interpretation of electrocardiograms (EKGs); (7) require adjustments in the relative value units for services in order to ensure budget neutrality; (8) require Medicare carriers to screen unassigned claims; (9) include antigens prepared by a physician on the physician fee schedule; and (10) specify the conditions under which the Secretary can recognize substitute billing arrangements between two physicians. (Sec. 5011) Requires the Secretary to develop relative values for pediatric physicians' services. Subchapter B: Outpatient Hospital Services and Ambulatory Surgical Services - Amends SSA title XVIII to: (1) extend the ten percent reduction in payments for capital-related costs of outpatient hospital services, as well as the 5.8 percent reduction in payments for other costs of such services; and (2) extend special payment rates for certain eye or eye and ear hospitals. (Sec. 5023) Directs the Secretary to suspend the annual update for ambulatory surgery payments for FY 1994. (Sec. 5025) Amends the Omnibus Budget Reconciliation Act of 1990 (OMBRA '90) to extend the cap on payments for intraocular lenses. Subchapter C: Durable Medical Equipment - Amends SSA title XVIII to: (1) revise payment rules for items of durable medical equipment (DME) and supplies; (2) remove aspirators and nebulizers from the category of DME items requiring frequent and substantial servicing, and specifically provide for payment of related accessories; (3) set forth requirements which suppliers of medical equipment and supplies must satisfy in order to qualify for Medicare reimbursement; (4) require development of standardized certificates of medical necessity forms; (5) require DME suppliers to submit claims to the carrier with jurisdiction over the geographic area including the patient's permanent residence; (6) place restrictions on certain DME supplier marketing and sales practices; (7) specify circumstances under which Medicare beneficiaries are not financially liable for covered items and services furnished by a supplier; (8) address adjustments made to unreasonable DME payment amounts; (9) determine payments for surgical dressings; and (10) reduce the DME fee schedule amount for transcutaneous electrical nerve stimulation devices. (Sec. 5032) Freezes payments during 1994 for parenteral and enteral nutrients, supplies, and equipment at 1993 levels. (Sec. 5034) Directs the Secretary to report to the Congress on: (1) the effect of the uniform criteria established pursuant to this Act for DME items; and (2) appropriate methodology for determining payment under Medicare for prosthetic devices and orthotics. (Sec. 5037) Amends SSA title XI to modify anti-kickback provisions. (Sec. 5042) Requires a report to the Congress on variations in DME supplier costs. Subchapter D: Part B Premium - Amends SSA title XVIII to extend current law with respect to the monthly Medicare part B premium for beneficiaries enrolled in Medicare. Subchapter E: Other Provisions - Revises provisions of SSA title XVIII, including: (1) to revise payments for clinical diagnostic laboratory tests; (2) to address the provision of x-ray services by rural health clinics and federally-qualified health centers; (3) to condition payment for mammograms on the certification status of the facility; and (4) to provide Medicare coverage of oral cancer drugs. (Sec. 5064) Amends the Omnibus Budget Reconciliation Act of 1986 (OMBRA '86) to extend the Alzheimer's Disease Demonstration. (Sec. 5066) Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 (COMBRA '85) to extend certain municipal health service demonstration projects. (Sec. 5069A) Requires a report to the Congress on annual payment limitations for outpatient physicial and occupational therapy services. Chapter 2: Provisions Relating to Parts A and B - Amends Medicare part C (Miscellaneous) provisions relating to Medicare parts A (Hospital Insurance) and B (Supplementary Medical Insurance) to: (1) eliminate requirements for special adjustments for administrative costs of hospital-based home health agencies; (2) make changes with regard to Medicare as secondary payor; (3) reduce payment for erythropoientin; (4) require nursing facilities and home health agencies to inform Medicare beneficiaries of the hospice benefit; and (5) require revision of the capitation payment methodology for health maintenance organizations (HMOs) to account for regional variations in application of Medicare secondary payor provisions. (Sec. 5073) Amends Medicare part B with regard to use of carriers to recover erroneous payments from primary payers. (Sec. 5072, 5074, and 5078) Requires: (1) a report on Medicare payments to hospitals for medical residency training program costs; (2) a report on the use of the new shared facility arrangement exception to ownership and compensation arrangements under the ban on certain referrals by physicians; and (3) establishment of a method of outreach to newly eligible Medicare beneficiaries qualifying for Medicaid payment of out-of-pocket expenses. (Sec. 5077) Amends OMBRA '86 to extend certain waivers under Medicare for the Watts Health Foundation. (Sec. 5079) Amends the Omnibus Budget Reconciliation Act of 1987 (OMBRA '87) to extend the waivers under Medicare for social health maintenance organization (SHMO) demonstration projects. Amends the Deficit Reduction Act of 1984 to require additional SHMO demonstration projects and permit one project to enroll Medicare end stage renal disease beneficiaries. (Sec. 5082) Amends the Omnibus Budget Reconciliation Act of 1990 (OMBRA '90) to revise the payment methodology for organizations under a risk-sharing contract with the Secretary. Chapter 3: Provisions Relating to Medicare Supplemental Insurance Policies - Amends OMBRA '90 and Medicare to make changes to Federal standards respecting the sale of Medicare supplemental insurance policies. Subtitle B: Medicaid Program and Other Health Care Provisions- Chapter 1: Medicaid Program - Subchapter A: Program Savings Provisions - Amends SSA title XIX to, among other things: (1) repeal the mandate that States cover personal care services under their Medicaid programs for all individuals entitled to nursing facility benefits; (2) allow States to establish formularies limiting coverage of prescription drugs under their Medicaid programs; (3) prohibit States from disregarding assets in cases where an individual has received payments under a long-term care policy; (4) address the liability of third parties to pay for care and services provided to Medicaid eligibles; (5) require States to have in effect certain laws relating to medical child support; and (6) make changes with regard to payments for disproportionate share hospitals. (Sec. 5117) Amends SSA to add a new title XXI requiring establishment of a Health Coverage Clearinghouse to identify third parties which may be liable for payment of health care items and services furnished to Medicare, Medicaid, Indian Health Service, and Maternal and Child Health Service beneficiaries. Subchapter B: Miscellaneous Provisions - Amends SSA title XIX to, among other things: (1) provide for the application under Medicaid of the physician self-referral prohibitions currently under Medicare; (2) require State maintenance of annual expenditures (adjusted) for State Medicaid fraud control units; (3) change treatment of HMO enrollees in determining the Medicaid inpatient utilization rate of a hospital seeking to qualify as a disproportionate share hospital; (4) raise, with respect to eligible States, Federal Medicaid matching payments for State expenses incurred in the provision of bona fide emergency medical services to undocumented aliens; (5) establish an option for States to make TB-infected individuals eligible for limited TB-related services; (6) require that mammographies paid for under Medicaid be conducted by a facility certified under the Mammography Quality Standards Act of 1992; and (7) make permanent the current law requirement for continued Medicaid coverage of families who lose eligibility for cash assistance under the Aid to Families with Dependent Chidren Program because they work. (Sec. 5132 and 5144) Amends SSA title XI to: (1) authorize an alternative intermediate remedy for redressing kickback offenses; (2) change procedures for initiation of a civil monetary penalty action; and (3) raise the ceiling on Federal Medicaid matching payments to Puerto Rico and other specified territories. (Sec. 5137) Extends the period during which the Secretary is required to waive application of the enrollment mix requirement under Medicaid for certain HMOs under the Dayton Area Health Plan, Inc. (Sec. 5138, 5146, and 5150) Amends the Omnibus Budget Reconciliation Act of 1989 with respect to the Tennessee Primary Care Network, certain demonstration projects for low-income pregnant women and children, and the Kent Community Hospital Complex and the Saginaw Community Hospital. (Sec. 5139) Directs the Secretary to waive application of the enrollment mix requirement under Medicaid with respect to the District of Columbia Chartered Health Plan, Inc.. (Sec. 5140) Amends the Family Support Act of 1988 to extend the period during which the Secretary is required to waive application of certain provisions of Medicaid law for the Minnesota Prepaid Demonstration Project. Subchapter C: Miscellaneous and Technical Corrections Relating to OMBRA '90 - Amends OMBRA '90 to make miscellaneous and technical corrections to various specified Medicaid-related provisions. Chapter 2: Universal Access to Childhood Immunizations - Amends the Public Health Service Act to entitle each State to the Federal purchase of enough pediatric vaccines to immunize each child in the State who is: (1) covered under title XIX (Medicaid) of the Social Security Act; (2) uninsured, or has insurance which does not cover vaccinations; or (3) an Indian. (Sec. 5181) Establishes the National Childhood Immunization Trust Fund. Exempts the vaccine program from reduction under the Balanced Budget and Emergency Deficit Control Act of 1985. Mandates State allotments for a registry of information on every child, including immunization data. Authorizes appropriations. Mandates grants to States to achieve objectives for immunizing U.S. children. Authorizes appropriations. (Sec. 5182) Amends the Omnibus Budget Reconcilation Act of 1989 to authorize appropriations from the Vaccine Injury Compensation Trust Funds to administer certain provisions of the National Vaccine Injury Compensation Program. Amends the Public Health Service Act to modify provisions regulating the effect on the statute of limitations of revisions to the Vaccine Injury Table. (Sec. 5183) Amends Medicaid provisions to require notifying all Medicaid-eligible persons under 21 of the need for immunizations. Adds grant entities under Public Health Service Act health provisions for residents of public housing to the list of entities within the definition of "Federally-qualified health center." (Sec. 5184) Allows Medicaid payments directly to vaccine manufacturers under certain programs. (Sec. 5185) Authorizes grants for demonstration projects providing comprehensive services to reduce the incidence of infant mortality and morbidity, fetal deaths, maternal mortality, fetal alcohol syndrome, and low birth weight. Authorizes appropriations. (Sec. 5186) Amends title V (Maternal and Child Health Services Block Grant) of the Social Security Act to authorize appropriations to carry out specified provisions. (Sec. 5187) Modifies compensation requirements regarding members of the National Advisory Council on the National Health Service Corps. Allows certain entities that are migrant, community, homeless, and public housing health services providers to elect certain treatment under the Public Health Service for purposes of malpractice actions. Removes provisions allowing waiver of rights to recover National Health Service Corps scholarship or loan repayment amounts after default. Subtitle C: Communications Licensing Improvement - Chapter 1: Competitive Bidding Authority - Licensing Improvement Act of 1993 - Amends the Communications Act of 1934 to empower the Federal Communications Commission (FCC) to use a system of competitive bidding in the granting of licenses involving the use of the electromagnetic spectrum (public airwaves). Outlines certain provisions, including: (1) uses to which such bidding may apply; (2) establishment by the FCC of a competitive bidding methodology; (3) alternative payment schedules for the use of airwaves; and (4) bidder and licensee qualifications. (Sec. 5205) Revises the FCC's regulatory authority in the mangagement of mobile communications services. Considers a person engaged in the provision of commercial mobile services to be a common carrier and, therefore, required to establish physical connections as required under the Communications Act. Prohibits State or local government imposition of any rate or entry regulation on commercial mobile service, but allows the FCC to grant a State petition to regulate rates under certain conditions. Chapter 2: Emerging Telecommunications Technologies - Emerging Telecommunications Technologies Act of 1993 - Amends the National Telecommunications and Information Administration Organization Act to require the Assistant Secretary of Commerce for Communications and Information and the FCC Chairman to conduct joint electromagnetic spectrum planning with respect to future spectrum requirements and promotion of efficient use of the spectrum. (Sec. 5222) Directs the Secretary to report to the President and the Congress identifying bands of frequencies that are allocated primarily for Government, are eligible for licensing, and are not required by the Government. Requires a report to the Congress on preliminary identification of reallocable bands of frequencies. Requires that an advisory committee be convened to assist in carrying out this Chapter. Directs certain actions after receipt of the advisory committee report on reallocation of band frequency assignments between Government and private uses. Authorizes the President to substitute alternative frequencies in the interest of national defense, governmental needs, public health or safety, or financial considerations. Directs the FCC to submit a plan for the distribution of reallocated frequency bands. Authorizes the President to reclaim reassigned frequencies. Chapter 3: Communications Technical Amendments - Sets forth corrections and technical amendments to communications provisions. Subtitle D: Energy Programs - Amends the Omnibus Budget Reconciliation Act of 1990 to extend from September 30, 1995, to September 30, 1998, the authority of the Nuclear Regulatory Commission to collect annual charges. Title VI: Committee on Foreign Affairs - States that the Committee on Foreign Affairs recommends changes in Federal law which would reduce direct spending under the Foreign Service Retirement and Disability Fund and the Foreign Service Pension System by requiring a three-month delay in cost-of-living adjustments for each year, FY 1994 through 1996. Title VII: Committee on the Judiciary - Amends the Omnibus Budget Reconciliation Act of 1990 to extend through FY 1998 the authorization for the collection of surcharges for use of the Patent and Trademark Office. Title VIII: Committee on Merchant Marine and Fisheries - Amends Federal shipping law to extend the years during which certain tonnage duties are imposed. (Sec. 8002) Declares the sense of the Congress that the inland waterways fuel tax should not be increased beyond those increases already mandated by law. Title IX: Committee on Natural Resources - Amends specified Federal law regarding the political union of the Commonwealth of the Northern Mariana Islands (Commonwealth) with the United States to repeal the direct grant asssitance for such Islands. Prescribes guidelines under which the United States commits its full faith and credit for specified payments to certain U.S. possessions and territories, including payments for capital improvements projects. Requires reports on the minimum wage and immigration policies of the Commonwealth. (Sec. 9002) Amends the Mineral Leasing Act to provide that, in calculating the amount to be paid to States of revenues derived from Federal onshore mineral and geothermal steam leasing receipts, 50 percent of the portion of the appropriation allocable for administration and enforcement shall be deducted from those receipts in approximately equal amounts each month prior to their division and distribution between the States and the United States. (Sec. 9003) Mandates the payment of a specified minimum flat claim maintenance fee and location fee by the holder of an unpatented mining claim, mill, or tunnel site in lieu of the assessment work and related filing requirements under certain Federal mining law. Exempts certain oil shale claims from the fee requirement. Waives fees under certain conditions. (Sec. 9004) Amends Federal reclamation laws to mandate that non-Federal recipients of water delivered by way of Federal facilities pay an operation and maintenance charge to the United States. Establishes the Natural Resources Restoration Fund for the benefit of fish and wildlife resources and habitat affected by Federal reclamation projects. (Sec. 9005) Amends the Land and Water Conservation Fund Act of 1965 to prohibit recreation user fees for campgrounds lacking specified amenities. Revises the terms of "Golden Age" passports in the National Park System. Establishes user fees for rights-of-way, tour vehicles or aircraft, and commercial telephone transmission facilities on Federal lands. (Sec. 9007) Directs the Secretaries of Energy and of the Interior adjust fees and other charges in order to recover the cost of Government services and establish a fee mechanism to recover Government costs of providing services which are currently free. (Sec. 9008) Directs the President to transmit in the annual budget an estimate of unfunded future Federal liabilities that are not accounted for in the budget itself. Title X: Committee on Post Office and Civil Service - Subtitle A: Civil Service - Delays the cost-of-living adjustments scheduled to take effect under certain Federal employee retirement systems during FY 1994 through 1996. (Sec. 1002) Amends the Civil Service and Federal Employees' Retirement Systems and the Foreign Service and Central Intelligence Agency systems to permanently eliminate the lump sum retirement option except for employees with a critical medical condition. (Sec. 1003) Eliminates the 1994 annual cost-of-living adjustment for Members of Congress and Federal employees. Amends the Ethics Reform Act of 1989 and other Federal law to modify the formulae for computing such adjustments for 1995 through 1997. (Sec. 1004) Amends Federal law to delay locality-based comparability payments until July of 1994. Limits the total amounts payable for locality payments between July 1, 1994, and September 30, 1998. Authorizes the President to specify locality payments less than the minimum amounts which would otherwise be required if necessary to comply with such limitations. Delays annual cost-of-living adjustments for Federal employees and Members of Congress until July of each year for the period between January 1, 1995, and December 31, 2003. Repeals provisions excluding senior executives from the limitation on the accumulation of annual leave. Prohibits cash awards during FY 1994 through 1998. Limits the average total number of civilian employees in the executive branch (except employees of the U.S. Postal Service and Postal Rate Commission) during FY 1994 through 1998. Requires the Director of the Administrative Office of United States Courts to apply the prohibitions and limitations of this Act with respect to annual cost-of-living adjustments and locality-based comparability payments to employees under the separate system of the Office. (Sec. 1005) Requires certain Federal Employees Health Benefits Program (FEHBP) plans to apply the Medicare part B limiting charges for physicians' services to enrolled retirees who are 65 or older and do not participate in Medicare part B. (Sec. 1006) Extends the proxy premium formula for determining Government contributions under FEHBP through contract year 1998 in the absence of a Government-wide indemnity benefit plan. Expresses the sense of the Congress that such extension should not be considered to reflect any view on the appropriateness, merits, or timing, or any other aspect of any comprehensive health care reform legislation. Subtitle B: Postal Service - Directs the U.S. Postal Service to make a specified additional payment into the Civil Service Retirement and Disability Fund and the Employee Health Benefits Fund to cover increases due to retirement cost-of-living adjustments and increases in health benefits costs. Subtitle C: Revenue Forgone Reform - Revenue Forgone Reform Act - Amends Federal postal service law to repeal the authorization of appropriations under the Overseas Citizens Voting Rights Act of 1975 and the Federal Voting Assistance Act of 1955 for mail sent at reduced postage rates. Revises provisions relating to the treatment of reduced-rate categories of mail. (Sec. 10203) Repeals certain Federal provisions authorizing appropriations to the Postal Service for certain accumulated operating indebtedness and directing the Postal Service to provide door or curbline delivery to certain permanent addresses. Authorizes appropriations for FY 1994 through 2035 to cover losses. (Sec. 10205) Prohibits reduced mailing rates for mail adverstising or offering products or services if: (1) the sale is not related to the purposes allowing mail at such rates; or (2) the mail matter involved is part of a cooperative mailing with a person not authorized to mail at reduced rates. Revises provisions with respect to the mailing rates of books. (Sec. 10207) Expresses the sense of the Congress that any legislation enacted after September 30, 1994, which would expand the class of mail eligible for reduced rates should provide for funding ensuring no losses to the Postal Service nor increases in rates for other classes of mail. Title XI: Committee on Public Works and Transportation - Amends the Federal Aviation Act of 1958 to revise fees charged for aircraft registration, designation as an aviation medical examiner, issuance of an airman's certificate to be a pilot and costs associated with processing forms for fuel system repairs. Requires fees be deposited in the Airport and Airway Trust Fund. (Sec. 11002) Amends the Flood Control Act of 1968 to authorize the Secretary of the Army to collect fees for the use of developed recreation facilities, including campsites, beaches, and boat launching ramps. Requires fees to be deposited into the Treasury account for the Corps of Engineers. Title XII: Committee on Veterans Affairs - Veterans Reconciliation Act of 1993 - Amends the Omnibus Reconciliation Act of 1990 to extend through September 30, 1998, the requirement that veterans with a certain minimum income level make copayments in exchange for receiving certain health care benefits through the Department of Veterans Affairs. Extends: (1) the requirement of a minimal copayment for medications received by veteran outpatients; (2) authority to recover the cost of veterans' services from third party insurers; (3) the authority of the Secretary of the Treasury to provide certain financial information for income verification purposes; (4) a monthly pension limitation for certain recipients of nursing home care covered under Medicaid; and (5) procedures applicable to liquidation sales on defaulted home loans to veterans. (Sec. 12006) Prohibits any FY 1994 cost-of-living adjustment in the rates of dependency and indemnity compensation paid to surviving spouses. (Sec. 12008) Increases the home loan fee charged to veterans for loans guaranteed by the Department, closed after September 30, 1993, and before October 1, 1998. (Sec. 12009) Reduces by one percentage point the FY 1994 cost-of-living adjustment for educational assistance benefits payable to active duty and reserve personnel under the Montgomery GI Bill educational assistance program. (Sec. 12010) Excludes a person who is not the natural or legally adopted child of the parent from eligibility for survivors' and dependents' educational assistance. Title XIII: Committee on Ways and Means: Savings - Subtitle A: Old-Age, Survivors and Disability Insurance Programs - Amends OMBRA '90 to require the Secretary to reestablish and maintain in service the same number of telephone lines to each local social security office that were in place as of September 30, 1989. (Sec. 13003) Makes amendments to SSA title II, including to: (1) permit States collecting social security numbers to use those numbers to eliminate duplicate names and names of convicted felons from jury source lists; (2) extend to all States the option to provide police officers and firefighters with social security coverage; (3) disregard the windfall elimination provision in computing any U.S. totalization benefit and the amount of a regular U.S. benefit of an individual who receives a foreign totalization benefit based in part on U.S. employment, and who does not receive any other pension based on noncovered employment; (4) provide that military pensions based wholly on service in the military reserves before 1988 shall not trigger application of the Government pension offset or windfall elimination provision to the individual's social security benefits; (5) permit the Department of Agriculture to share its list of names, social security numbers, and employer identification numbers of the owners of retail grocery stores which redeem food stamps with other Federal agencies for the purpose of investigating food stamp fraud and other crimes; and (6) prohibit a State from using social security numbers in the administration of any driver's license or motor vehicle registration law where the State has not contracted to provide death certificate and related information to the Secretary, or where use of death information is restricted. (Sec. 13005) Exempts from payment liability and penalties ministers who were American citizens and residents of Canada prior to the 1984 totalization agreement between the United States and Canada and failed to file a tax return or pay self-employment taxes. (Sec. 13010) Amends IRC to: (1) authorize the Secretary of the Treasury to disclose information from tax returns on individuals' mortality status to the Secretary for eipdemiological research purposes; (2) coordinate the collection of domestic service employment taxes with the collection of income taxes; and (3) change threshold requirements with respect to social security employment taxes on domestic services. (Sec. 13015) Requires the Secretary to study and report to the Congress on the rising costs of disability benefits. (Sec. 13016) Amends the Social Disability Amendments of 1980 to extend the Secretary's authority to conduct disability work incentive demonstration projects. Subtitle B: Human Resources Amendments - Chapter 1: Child Welfare Services, Foster Care, and Adoption Assistance - Amends SSA title IV part B (Child-Welfare Services) to, among other thing: (1) create a capped entitlement program to provide child welfare services designed to strengthen and preserve families; (2) repeal provisions linking the payment of title IV part B funds to the implementation of protections for children in foster care; (3) require State part B plans to contain a description of the specific measures taken by the State to comply with the Indian Child Welfare Act; and (4) provide for child welfare traineeships. (Sec. 13212) Directs the Secretary to provide grants for State courts to improve foster care placement and adoption proceedings. (Sec. 13216) Amends SSA title IV part E (Foster Care and Adoption Assistance) (FCAA) to change the reimbursement policy with respect to foster care maintenance payments made on behalf of certain children whose adoption has been set aside by a court or whose voluntary placement in foster care has been judicially determined to be in the best interests of the child. Requires States to review their foster care maintenance payment and adoption assistance levels. Requires the health and education records in each child's case plan include a record that the foster care provider was advised (where appropriate) of the child's eligibility for certain Medicaid services. Makes permanent the authorization for the independent living program. Sets forth case plan requirements for children placed in foster care a substantial distance from their homes or in a different State. (Sec. 13218) Directs the Secretary to study and report to the Congress on the ways in which States implement the reasonable efforts requirements for State part E plans. (Sec. 13225) Amends OMBRA '89 to extend permanently (and retroactively to October 1, 1992) the level of Federal reimbursement under part E for the training of personnel employed by the State or local child welfare agency, and for the training of foster and adoptive parents. (Sec. 13227) Amends SSA title XI part A to overturn certain limitations in Suter v. Artist M. on private enforceability of State plan requirements. (Sec. 13232) Prohibits the Secretary, until October 1, 1994, from reducing any payment to any State under parts B or E because of State noncompliance with part B foster care protections. (Sec. 13233) Requires the Secretary to make grants to eligible institutions to train individuals to deliver culturally sensitive and bilingual child welfare services in border areas with Mexico. Authorizes approprations. Chapter 2: Child Support Enforcement - Amends SSA title IV part D (Child Support and Establishment of Paternity) to set up new paternity establishment performance standards and procedures for State child support enforcement programs. Outlines State plan requirements. Requires State child support enforcement agencies to periodically report, at no charge, the names and amounts of obligors at least two months delinquent in child support payments to bona fide consumer reporting agencies. Chapter 3: Supplemental Security Income - Amends SSA title XVI (Supplemental Security Income) (SSI) and other Federal law to require the Social Security Administration to charge States fees for the Federal cost of administering supplemental SSI payments. (Sec. 13252) Amends OMBRA '90 to make permanent the exclusion of State and local relocation assistance from countable income under SSI. (Sec. 13253-13256) Amends SSA title XVI to: (1) deem to be living in a household a spouse or parent of family members on SSI who is absent because of active duty military assignment; (2) exclude hazardous duty pay from countable income; (3) continue SSI benefits to children who are U.S. citizens if they received SSI in the United States and then accompanied their parents on military assignment to a U.S. territory or possession; and (4) extend the SSI definition of disability for children under 18 to any person under age 18. (Sec. 13257) Exempts income of up to $2,000 per year received by individual Indians that is derived from leases on trust or restricted Indian lands in determining eligibility and benefit levels under AFDC (SSA title IV part A) and SSI. Chapter 4: Aid to Families with Dependent Children - Amends SSA title IV part A to: (1) reduce to 50 percent the enhanced Federal matching available for certain categories of State administrative expenses; (2) make optional a State's verification of an individual's immigration status with the Immigration and Naturalization Service through an immigration status verfication system; (3) delay Federal requirements regarding AFDC-UP participation rates; and (4) increase the amount of stepparent earnings disregarded in determining the eligibility and benefit amounts of AFDC recipients and applicants. (Sec. 13263) Amends part F (Job Opportunities and Basic Skills Training Program) (JOBS) to require development of criteria for performance standards in the JOBS program, rather than performance standards themselves. (Sec. 13264) States that the Congress declares: (1) it is the responsibility of the Federal Government to reduce family dependence on income from welfare programs, to assist them toward self-sufficiency, and to increase the living standards of low-income families; and (2) the Federal Government should help welfare recipients and individuals at risk of welfare participation to improve education and job skills, to obtain access to child care and support services, and to take other steps as may assist them to become financially independent. Directs the Secretary to develop welfare participation measures and predictors, and report annually on welfare participation to specified congressional committees. Establishes the Advisory Board on Welfare Participation. (Sec. 13265) Directs the Secretary to provide for a demonstration project offering low-income residents of Milwaukee, Wisconsin, employment, wage supplements, health and child care, and job counseling and training. (Sec. 13266 and 13270) Amends the Family Support Act of 1988 to: (1) delay the requirement for implementation of the Unemployed Parent program in Puerto Rico, Guam, the Virgin Islands, and American Samoa until the limitations on Federal matching payments with respect to AFDC and FCAA maintenance payments are repealed; and (2) extend the authorization for early childhood development projects. (Sec. 13269) Amends OMBRA '87 to extend New York State's Child Assistance Program demonstration. (Sec. 13267) Amends SSA title XI to provide that, with respect to AFDC, one adult member of a household may sign a declaration attesting to the citizenship or satisfactory immigration status of other household members. Chapter 5: Unemployment Insurance - Amends IRC and SSA title III (Unemployment Compensation) to provide for the treatment of short-time compensation programs under which individuals whose workweeks have been reduced by at least ten percent (especially as an alternative to a temporary layoff) are eligible for unemployment compensation, under certain conditions. (Sec. 13275) Amends the Federal-State Extended Unemployment Compensation Act of 1970 to increase the reimbursement rate and repeal special eligibility requirements under the extended unemployment program. (Sec. 13276 and 13277) Amends IRC to extend the current Federal unemployment tax rate and require disclosure of tax information to the Railroad Retirement Board for administration of the Railroad Retirement and Railroad Unemployment Insurance Acts. Chapter 6: Technical Provisions - Makes technical corrections related to the income security and human resources provisions of OMBRAs '89 and '90. (Sec. 13283) Amends SSA title XVI to repeal certain obsolete provisions relating to treatment of the earned income tax credit. Subtitle C: Medicare Program - Chapter 1: Provisions Relating to Part A -Subchapter A: Elimination of Inflation Update for Services Provided under Part A: - Amends SSA title XVIII (Medicare) to eliminate updates for inpatient hospital services and hospice care under Medicare part A in FY 1994 and 1995. (Sec. 13402) Prohibits the Secretary from applying an update factor to the cost limits for skilled nursing facility cost reporting periods beginning in FY 1994 and 1995. Subchapter B: Other Provisions Relating to Part A - Amends SSA title XVIII to, among other things: (1) provide that a change in classification of hospitals from one area to another cannot result in a reduction in the wage index for an urban area if the area has an age index below the rural wage index for the State or if the area is the only urban area in a State with no rural areas; (2) change certain standards for designating metropolitan statistical areas that are used in determining treatment of hospitals in rural counties adjacent to urban areas; (3) require the phase out of payments for day outlier cases starting in FY 1995; (4) authorize appropriations for the Essential Access Community Hospital (EACH) demonstration program; (5) provide for a prospective payment system for outpatient rural primary care hospital services; (6) continue special payments for Medicare-dependent, small rural hospitals for discharges occurring through FY 1994, with reduced payments for certain discharges; (7) allow to participate in Medicare hospitals where the care of patients receiving qualified psychologist services is under a clinical psychologist; (8) require skilled nursing facilities to inform beneficiaries of the hospice benefit under Medicare; (9) reduce the part A premium, on a phase-in basis, for individals with 30 or more quarters of social security coverage (and their spouses); (10) require periodic updating of salary equivalency guidelines for physical therapy and respiratory therapy services; and (11) provide that diagnosis-related group (DRG) window provisions will not apply to hospitals that are not paid on a DRG basis. (Sec. 13414) Amends OMBRA '87 to: (1) reauthorize and extend the rural health transition grant program; and (2) provide that all hospitals classified as regional referral centers on September 30, 1992, shall retain such status through FY 1994. (Sec. 13418) Amends OMBRA '90 to require the Secretary to continue limited-service rural hospital demonstration projects through calendar 1995. (Sec. 13419) Amends OMBRA' 89 to extend the hemophilia pass-through program. (Sec. 13420) Declares that, in the case of a State with a Medicare-approved payment system, no other provision of law shall be construed as preventing the system from providing that payment for covered services be made on the basis of rates provided for under such system. (Sec. 13423) Prohibits the Secretary from taking action to recover certain amounts paid by Medicare to uniformed services treatment facilities in Boston, Baltimore, and Seattle for services provided between October 1, 1986, and December 31, 1989, except to the extent that funds are made available for that purpose under the Department of Defense Appropriations Act, 1993. Requires a report to the Congress on establishment of joint medical facilities among the Department of Defense, the Department of Veterans' Affairs, and other entities. (Sec. 13424 and 13425) Requires the Secretary to: (1) review ]the DRGs assigned to discharges of patients with intractable epilepsy; (2) revise the assignment of discharges to such groups as the Secretary considers appropriate to account for the resource requirements of such patients; and (3) begin collecting data necessary to compute a skilled nursing facility wage index adjustment to the routine service cost limits required under Medicare. Requires the Prospective Payment Assessment Commission to report to the Congress on the impact of applying routine per diem cost limits for skilled nursing facilities on a regional basis. (Sec. 13429) Allows hospitals that have been reclassified from urban to rural as a result of revisions to metropolitan statistical area definitions issued by the Office of Management and Budget on December 28, 1992, to apply to the Medicare Geographic Classification Review Board for reclassification in FY 1994. Chapter 2: Provisions Relating to Part B: Subchapter A: Elimination of Inflation Update - Amends SSA title XVIII part B to eliminate the inflation update for physician and related professional services and other items and services. (Sec. 13432) Freezes payments for enteral and parenteral nutrients, supplies and equipment, rural health clinic, federally qualified health center, and comprehensive outpatient rehabilitation facility services, dialysis services, and other part B items and services. Subchapter B: Physicians' Services - Amends SSA title XVIII part B to, among other things: (1) repeal the OMBRA '90 prohibition on separate payments for EKG interpretations; (2) repeal the reductions in payments to new physicians and practitioners; (3) prohibit changing the methodology in effect as of January 1, 1992, for calculating anesthesia time in the fee schedules; (4) revise requirements with respect to geographic adjustment factors and beneficiary liability for amounts billed above the limiting charge; (5) require pre-payment screening by carriers of unassigned claims submitted by nonparticipating physicians; (6) require the Explanation of Benefits form to contain information on amounts billed in excess of the applicable limiting charge; (7) specify the practitioners who may only bill for services on an assignment-related basis; (8) include antigens prepared by a physician on the physician fee schedule; (9) prohibit the imposition of user fees in specified circumstances in the administration of claims relating to physicians' services; and (10) specify the conditions under which the Secretary can recognize substitute billing arrangements between two physicians. (Sec. 13444) Requires the Secretary to revise and report to specified congressional committees on the data necessary to revise geographic indices. Requires the Physician Payment Review Commission to develop criteria for use in redefining the localities used within States for adjusting physicians' fees. (Sec. 13446) Requires the Secretary to develop relative values for the full range of pediatric physicians' services and report to the Congress. Subchapter C: Ambulatory Surgical Center Services - Makes amendments identical to those made above to the Medicare program and OMBRA'90 under subchapter B of chapter 1 of title V of this Act with respect to eye and eye and ear hospitals and intraocular lenses. (Sec. 13452) Requires the Secretary to report to the Congress on the costs to providers of intraocular lenses provided to individuals enrolled under Medicare part B. Subchapter D: Durable Medical Equipment - Makes amendments similar to those made above to the Medicare program and SSA title XI under subchapter C of chapter 1 of title V of this Act with respect to durable medical equipment and kick-backs. (Sec. 13468) Subjects ostomy supplies, tracheostomy supplies, and urologicals to national payment limits. Subchapter E: Other Provisions - Makes amendments similar to those made above to the Medicare program, OMBRA '86, and COMBRA '85 under subchapter E of chapter 1 of title V of this Act with respect to oral cancer drugs and the treatment of certain Indian health programs and facilities as federally-qualified health centers, and the extension of Alzheimer's disease and municipal health service demonstration projects. (Sec. 13471) Amends SSA title XVIII to, among other things: (1) freeze at the 1992 level the conversion factor used to determine payments to medically directed certified registered nurse anesthetists; (2) cap the part B premium penalty for late enrollment for Federal employees who meet certain conditions; and (3) establish statutory definitions for speech language pathologist and audiologists. (Sec. 13473) Provides for uniform coverage of "off-label" drugs used in anti-cancer therapy. Requires a report to specified congressional committees on Medicare coverage of patient care costs associated with clinical trials of new cancer therapies. Subchapter F: Part B Premiums - Duplicates the amendment to the Medicare program made above under subchapter D of chapter 1 of subtitle A of title V of this Act with respect to the monthy Medicare part B premium. Chapter 3: Provisions Relating to Parts A and B -Subchapter A: Elimination of Updates - Amends SSA title XVIII to eliminate updates in payments to hospitals for the direct costs of graduate medical education for cost reporting periods beginning during FY 1994 and 1995. (Sec. 13502) Prohibits the Secretary from providing any update in the cost limits for home health services for cost reporting periods beginning during FY 1994 and 1995. Subchapter B: Medicare Secondary Payer Provisions - Makes amendments similar to those under chapter 2 of subtitle A of title V of this Act with respect to Medicare as secondary payer. Subchapter C: Physician Ownership and Referral - Amends SSA title XVIII to: (1) apply the ban on certain referrals by physicians to all payers, extending it to cover additional specified health services as well as new exceptions; (2) expand current standards used to define a group practice; and (3) provide that Federal law shall not preempt State laws that related to referrals not covered under the ban, or that relate to referrals covered under the ban but are even more restrictive. Subchapter D: Other Provisions - Sets forth measures similar to those under chapters 1 and 2 of subtitle A of title V of this Act with respect to: (1) interest payments on clean claims; (2) payments for erythropoietin; (3) qualified Medicare beneficiary outreach; (4) social health maintenance demonstrations; (5) the second surgical opinion program under SSA title XI; (6) hospice notification; and (7) Medicare capitation payments. (Sec. 13551) Requires the Secretary to redetermine the full-time-equivalent (FTE) resident amount to reflect the amount that would be allowed if the hospital had been liable to pay FICA taxes or make other specified retirement contributions for residents during the base year, but did not make such payments, yet now must do so as a result of OMBRA '90. Amends SSA title XVIII to: (1) provide for adjustments for certain publicly funded family residency programs; (2) extend on a graduated basis to three years (after 1997) the current one-year period following a transplant procedure during which Medicare covers immunosuppressive drug therapy for beneficiaries who have received organ transplants; and (3) provide that user fees imposed under the Clinical Laboratories Improvement Act of 1967 are not subject to the general ban on user fees for determining compliance with any requirement of Medicare. (Sec. 13560) Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to provide that to the extent that appropriations are enacted providing budget authority for Medicare administrative costs above a base level spending in FY 1992 of $1.526 billion, the appropriate discretionary spending limits shall be adjusted to accommodate additional budget authority in FY 1994 and 1995. Chapter 4: Medicare Supplemental Insurance Policies - Amends OMBRA '90 and Medicare to make specified changes to Federal standards respecting the sale and regulation of Medicare supplemental insurance policies. Chapter 5: Treatment of Certain State Health Care Programs - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide that: (1) the Hawaii Prepaid Health Care Act will not be preempted by ERISA unless the Secretary of Labor notifies the Governor of Hawaii that certain conditions exist; and (2) State tax laws relating to employee benefit plans will continue to be preempted. Subtitle D: Customs and Trade Provisions - Amends the Tariff Act of 1930 to authorize appropriations for FY 1994 and 1995 for the United States International Trade Commission (ITC). Prohibits use of funds for any special study, requested by the executive branch unless the ITC is reimbursed. (Sec. 13601) Amends the Customs Procedural Reform and Simplification Act of 1978 to authorize appropriations for FY 1994 and 1995 for the United States Customs Service for noncommercial and commercial operations, and the air and marine interdiction programs. Amends the Trade Act of 1974 to authorize appropriations for FY 1994 and 1995 for the Office of the United States Trade Representative. (Sec. 13602) Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) to extend the authority of the Secretary of the Treasury to collect customs user fees through September 30, 1998. (Sec. 13603) Amends the Trade Act of 1974 to remove the Union of Soviet Socialist Republics from the list of countries ineligible for designation as a beneficiary developing country under the Generalized System of Preferences (GSP). Extends duty-free treatment provided under the GSP through September 30, 1994. (Sec. 13604) Extends the worker trade adjustment assistance program (trade adjustment assistance benefits for workers adversely affected by import competition or the relocation of U.S. production facilities abroad), and authorization of appropriations, from FY 1993 through FY 1996. (Sec. 13605) Amends the Omnibus Trade and Competitiveness Act of 1988 to extend the authority of the President, for a specified period of time, to enter into trade agreements with foreign countries for the reduction or elimination of tariff or nontariff barriers if the Uruguay Round of multilateral trade negotiations under the General Agreement on Tariffs and Trade (GATT) has not resulted in such trade agreements by May 31, 1993. Provides that implementing bills involving tariff and nontariff trade agreements shall be effective only if, among other things, the President, at least 120 calendar days (currently, 90 days) before he enters into such an agreement, notifies the Congress of his intention and publishes such intention in the Federal Register. Extends congressional "fast track procedures" to such implementing bills through April 16, 1994. (Sec. 13606) Amends the Federal Trade Act of 1974 to eliminate the East-West Trade Statistics Monitoring System. Subtitle E: Customs Officer Pay Reform - Revises the pay system for United States Customs Service inspectors. (Sec. 13701) Amends the Tariff Act of 1930 to prohibit merchandise or passengers from foreign places, or merchandise being transported from one port to another, from being unladen from carrying vehicles during overtime hours (currently, at night). (Sec. 13702) Authorizes cash awards to customs officers for foreign language proficiency. (Sec. 13703) Amends COBRA to provide for reimbursement of appropriations from the Customs User Fee Account for agency retirement contributions. (Sec. 13704) Amends Federal law with regard to the treatment of certain pay of customs officers for retirement purposes. (Sec. 13705) Revises COBRA congressional reporting requirements respecting Account reimbursements. Requires additional General Accounting Office reports to the Congress on financing of overtime inspectional services through user fees. Title XIV: Revenue Provisions - Revenue Reconciliation Act of 1993 - Subtitle A: Training and Investment Incentives - Part I: Provisions Relating to Education and Training - Makes permanent after June 30, 1992: (1) the tax exclusion of employer-provided educational assistance; and (2) the targeted jobs credit. Allows the use of the targeted jobs credit, with limitations, for the hiring of a qualified participant in an approved school-to-work program. Part II: Investment Incentives - Subpart A: Research Credit - Makes permanent the credit for increasing research activities. Modifies the fixed base percentage of such credit for startup companies for taxable years after 1993. Subpart B: Capital Gain Provisions - Allows a taxpayer other than a corporation to exclude from gross income 50 percent of gain from the sale or exchange of qualified small business stock held for more than five years. Set forth rules and limitations for such exclusion. Treats one-half of such exclusion as an item of tax preference for minimum tax purposes. (Sec. 14114) Allows the rollover of gain from the sale of publicly traded securities into specialized small business investment companies. Subpart C: Modifications to Minimum Tax Depreciation Rules - Modifies the method of determining the depreciation deduction for certain personal property placed in service after 1993. Eliminates the depreciation adjustment for computing adjusted current earnings for such property. Subpart D: Increase in Expense Treatment for Small Business - Increases the dollar limitation on the election to expense certain depreciable small business assets. Part III: Tax-Exempt Bond Provisions - Provides a complete tax exemption (currently a 75 percent tax exemption) for bonds used to finance high-speed intercity rail facilities. (Sec. 14122) Permanently extends the authority to issue qualified small issue bonds to finance manufacturing facilities and farm property. Part IV: Expansion and Simplification of Earned Income Tax Credit - Repeals certain interaction rules with respect to the medical expense deduction, the deduction for health insurance, and the dependent care credit. Revises credit and phaseout percentages for 1994. Part V: Incentives for Investment in Real Estate - Subpart A: Extension of Qualified Mortgage Bonds and Low-Income Housing Credit - Makes permanent: (1) the authority to issue qualified mortgage bonds and qualified mortgage credit certificates; and (2) the low-income housing credit. (Sec. 14142) Provides that assistance under the HOME Investment Partnerships Act should not result in certain buildings being federally subsidized. Subpart B: Modification of Passive Loss Rules - Provides for the treatment of rental real estate activities under the limitations on losses from passive activities. Subpart C: Provisions Relating to Real Estate Investments by Pension Funds - Modifies exceptions to the exclusion of real property acquired by a qualified organization from the meaning of acquisition indebtedness. Makes certain exceptions inapplicable to sales out of foreclosure by a financial institution. (Sec. 14145) Repeals the special rule for publicly traded partnerships with respect to the treatment of unrelated business taxable income. (Sec. 14146) Permits a tax-exempt title-holding company to receive unrelated business taxable income if the unrelated income is incidentally derived from the holding of real property. (Sec. 14147) Excludes from unrelated business taxable income: (1) gains from the sale, exchange, or other disposition of real property acquired from financial institutions that are in conservatorship or receivership; and (2) loan commitment fees and certain option premiums. Provides for the tax treatment of pension fund investments in real estate investment trusts. Subpart D: Discharge of Indebtedness - Excludes from gross income the income from the discharge of qualified real property business indebtedness. Subpart E: Increase in Recovery Period for Nonresidential Real Property - Increases the depreciation recovery period for nonresidential real property. Part VI: Luxury Tax - Repeals the luxury excise tax on boats, aircraft, jewelry, and furs. (Sec. 14162) Modifies the luxury excise tax on automobiles to index the threshold for inflation occurring after 1990 and make such tax applicable to the first retail sale. Exempts from the luxury excise tax parts for accessories installed for use of passenger vehicles by disabled individuals. (Sec. 14163) Extends the current diesel fuel excise tax to diesel fuel used by noncommercial motorboats. Retains such taxes in the General Fund of the Treasury. Part VII: Other Changes - Repeals the tax preferences for the appreciated property charitable deduction. Disallows an adjustment related to the earnings and profits effects of any charitable contribution from being made in computing adjusted current earnings. (Sec. 14171) Requires Secretary of the Treasury to report to specified congressional committees on the development of a procedure for taxpayers to seek an agreement with the Secretary on the value of tangible personal property prior to the donation of such property to a qualifying charitable organization. (Sec. 14172) Amends the Railroad Retirement Solvency Act of 1983 to make permanent the treatment of certain railroad retirement benefits as received under employer plans. (Sec. 14173) Provides for the temporary extension of the deduction of health insurance costs of self-employed individuals. Subtitle B: Revenue Increases - Part I: Provisions Affecting Individuals- Subpart A: Rate Increases - Lowers the tax rates for certain taxpayers and increases the tax rate for certain higher incomes. Imposes a surtax on certain higher incomes. (Sec. 14203) Increases the tentative minimum tax for taxpayers other than corporations. (Sec. 14204) Makes permanent the overall limitation on itemized deductions and the phaseout of personal exemptions for high-income taxpayers. (Sec. 14206) Sets forth provisions to prevent the conversion of ordinary income to capital gain in certain financial transactions. Repeals certain exeptions to market discount rules. Provides for the treatment of purchases of stripped preferred stock after April 30, 1993. Revises methods of: (1) computing the limitation on the deductibility of investment interest; and (2) determining substantial appreciation of partnership inventory items. Subpart B: Other Provisions - Repeals the limitation on the amount of wages subject to the health insurance employment tax. (Sec. 14208) Increases and makes permanent the highest estate and gift tax rate. (Sec. 14209) Reduces the deduction for business meals and entertainment expenses. (Sec. 14210) Disallows a tax deduction for social club membership dues, except for employee recreational expenses. (Sec. 14211) Disallows a deduction as a trade or business expense remuneration to certain employees in excess of $1 million. (Sec. 14212) Reduces the compensation taken into account in determining contributions and benefits under qualified retirement plans. (Sec. 14213) Removes qualified residence sales, purchases, or leases and meals from the deduction for moving expenses. (Sec. 14214) Revises the limitation on using the preceding year's tax to calculate an individual's estimated tax payments. (Sec. 14215) Increases the amount of social security and tier 1 railroad retirement benefits to be included in the gross income of certain taxpayers. Part II: Provisions Affecting Business - Increases the tax rate for corporate income in excess of $10 million and the tax rate on personal service corporations. (Sec. 14222) Denies a tax deduction for lobbying expenses. Subjects lobbying organizations to special reporting requirements. (Sec. 14223) Requires any security which is inventory in the hands of the dealer to be included in inventory at its fair market value. Requires any dealer in securities that holds any security which is not in inventory at the close of any taxable year to: (1) recognize gain or loss as if the security were sold on the last business day of the taxable year; and (2) take into account any such gain or loss for such year (the mark-to-market requirement). (Sec. 14224) Requires taking into account: (1) certain Federal Savings and Loan Insurance Corporation (FSLIC) assistance as compensation for loss; and (2) FSLIC assistance for any debt for determining whether such debt is worthless and the amount of any addition to a reserve for bad debts. (Sec. 14225) Increases the required annual payment for corporations that fail to pay estimated income tax. Modifies the periods for applying such annualization. (Sec. 14226) Limits the Puerto Rico and possession tax credit to 60 percent of the possession corporation's qualified possession wages. (Sec. 14227) Modifies the limitation on corporate deductions for interest paid to related persons to take into account disqualified guarantees of indebtedness and the imposition of a gross basis tax. Part III: Foreign Tax Provisions - Subpart A: Current Taxation of Certain Earnings of Controlled Foreign Corporations - Requires U.S. shareholders of controlled foreign corporations to include in gross income a pro rata share of the corporation's excess passive assets. Modifies the rule on taxation of investment in U.S. property and takes into account excessive passive assets. Requires a report on investments by controlled foreign corporations in U.S property. (Sec. 14233) Excepts from foreign personal holding income dividends attributable to earnings and profits of the distributing corporation accumulated during any period which the person receiving such dividend did not hold such stock. Requires the establishment of an excess limitation account by taxpayers who receive foreign tax credits in a year they receive previously taxed earnings and profits. Subpart B: Allocation of Research and Experimental Expenditures - Reduces the amount allowed as allocation and apportionment of research and experimental expenditures from sources within the United States. Subpart C: Other Provisions - (Sec. 14235) Excludes passive dividends or interest income from foreign oil and gas income. (Sec. 14236) Modifies accuracy-related penalties for tax underpayments. (Sec. 14237) Denies the inclusion of certain contingent interest in the exemption for portfolio interest for nonresident aliens. (Sec. 14238) Authorizes the Secretary of the Treasury to prescribe regulations recharacterizing any multiple-party financing transaction as a transaction directly among any two or more of such parties when appropriate to prevent tax avoidance. Part IV: Energy Tax Provisions - Subpart A: Energy Tax Based on Btu Content - Imposes an excise tax on the following energy products: (1) taxable refined petroleum products removed from a U.S. refinery or terminal entered into the United States for consumption, use, or warehousing, and sold to a nonregistered person; (2) natural gas removed from any U.S. pipeline, entered into the United States for consumption, use, or warehousing, and entered into any nonregistered pipeline; (3) coal received at any facility for use as a fuel at such facility; and (4) the sale of electricity to ultimate users in the United States and the use of electricity which was not subject to such tax. Bases the rate of tax on such products on the applicable Btu factor and content. (Sec. 14241) Provides for refunding certain amounts to ultimate vendors of petroleum used for heating oil and international commercial transportation. Repays certain sums to persons who use petroleum to produce calcined coke. Provides excise tax exemptions for certain uses. Refunds the tax paid by certain users of methane recovered from biomass or coal mining. Imposes a tax on the use of any fossil fuel: (1) in the manufacture or production of a fuel other than at a U.S. refinery; or (2) as a fuel. Imposes a tax on floor stock of taxable fuels held on the date of the tax increase. Allows a credit against such tax. Provides for such tax increases to begin July 1, 1994. Imposes a Btu tax on certain imported products that contain significant levels of direct energy inputs that would be taxable if the products were manufactured in the United States. Imposes a penalty on persons who sell dyed fuel for taxable uses. Subpart B: Modifications to Tax on Diesel Fuel - Imposes an excise tax on diesel fuel. Exempts from such tax diesel fuel: (1) used by trains and intercity, local, or school buses; and (2) which is dyed or marked in accordance in regulations. (Sec. 14242) Provides that the Airport and Airway Trust Fund financing rate does not apply to aviation fuel sold by a producer or importer for use by the purchaser in a nontaxable use. Imposes a civil penalty on persons who use reduced-rate fuel for a taxable use. (Sec. 14243) Imposes a floor stocks tax on any person holding diesel fuel April 1, 1994. Subpart C: Extension of Motor Fuel Tax Rates; Increased Deposits Into Highway Trust Fund - Increases the tax on gasoline and diesel fuels for purposes of the Highway Trust Fund financing rate. Increases the amount to be transferred to the Mass Transit Account from such Fund. Part V: Compliance Provisions - Requires information reporting on payments to corporations for services. (Sec. 14252) Modifies provisions concerning substantial understatement and return-preparer penalties to allow reasonable cause exceptions. (Sec. 14253) Requires certain financial entities (including the Federal Deposit Insurance Corporation, the Resolution Trust Corporation, and the National Credit Union Administration, and their successors or subunits) to file information returns regarding discharges of indebtedness of $600 or more. Part VI: Treatment of Intangibles - Allows an amortization deduction with respect to certain intangible property, including goodwill, that is acquired and held by a taxpayer in connection with the conduct of a trade or business or an activity engaged in for the production of income. Part VII: Miscellaneous Provisions - Establishes substantiation requirements for charitable contributions of $750 or more. (Sec. 14272) Sets forth disclosure requirements for an organization that receives a quid pro quo contribution (payment made partly as a contribution and partly in consideration for goods or services provided to the payor by the donee organization). Imposes a penalty for failure to make such disclosure. (Sec. 14273) Expands the 45-day interest-free period for refunding tax overpayments to all returns, amended returns, and claims for refunds. Provides that if interest is not refunded within 45 days after the taxpayer files an amended return or claim for refund, interest will be paid only for periods after the date on which the return or claim is filed. (Sec. 14274) Denies the business travel expense deduction for spouses, dependents, or others. (Sec. 14275) Increases the withholding rate for supplemental wage payments. Subtitle C: Empowerment Zones and Enterprise Communities - Part I: Empowerment Zones and Enterprise Communities, Etc. - Provides for the designation of 100 tax enterprise communities and ten enpowerment zones between 1993 and 1996: (1) by the Secretary of Housing and Urban Development for urban areas; (2) by the Secretary of Agriculture for rural areas; and (3) by the Secretary of the Interior for Indian reservations. (Sec. 14301) Sets forth eligibility criteria. Makes certain buildings in such communities or zones eligible for the low-income housing credit applicable to buildings in high-cost areas. Provides for the issuance of enterprise zone facility bonds in enterprise communities and enpowerment zones in a manner similar to exempt facility bonds. Excludes enterprise zone facility bonds from the interest deduction limitations on financial institutions. Provides States an additional housing credit ceiling for each zone and community through 1996. Allows a limited empowerment zone employment credit to employers for a percentage of qualified zone wages paid during calendar years 1994 through 2004. Allows businesses a zone resident empowerment savings credit of 50 percent of the qualified savings contributions made by an employer to a defined contribution plan on behalf of a zone employee. Limits the credit amount based on the employee's compensation. Increases the limitation on expensing certain depreciable business assets. Increases the volume cap applicable to enterprise zone facility bonds if the business owners meet specified ownership requirements with regard to abiding in such zones. (Sec. 14302) Allows use of the targeted jobs credit for hiring empowerment zone residents. Part II: Credit for Contributions to Certain Community Development Corporations - Allows a general business tax credit for contributions to selected community development corporations for low-income individuals who are residents of the operational area of the community. Subtitle D: Other Provisions - Part I: Disclosure Provisions - Extends the authority to disclose tax return information to the Department of Veterans Affairs through September 30, 1998. (Sec. 14402) Authorizes the disclosure of certain tax return information to the Department of Education to implement the direct student loan program and to the Department of Housing for income verification. Part II: User Fee Provisions - Requires establishment of a program requiring the payment of user fees for the processing of applications for certificates of alcohol label approval and exemption, formula reviews, and statements of process (including laboratory tests). (Sec. 14412) Removes authority to use the Harbor Maintenance Trust Fund for administrative expenses of certain customs fee collections. (Sec. 14413) Increases the tax on fuel used on commercial transportation on inland waterways. Part III: Public Debt Limit - Increases the public debt limit and repeals the temporary limit on such increase. Part IV: Vaccine Provisions - Makes permanent: (1) the excise tax on certain vaccines; and (2) the authority to pay compensation from the Vaccine Trust Fund under the National Vaccine Injury Compensation Program for certain damages resulting from vaccines administered after September 30, 1988. Directs the Secretary of the Treasury to report to specified congressional committees on uses of such Fund. (Sec. 14431) Imposes a floor stocks tax on taxable vaccines. (Sec. 14432) Requires contribution coverage under group health plans of the costs of pediatric vaccines. (Sec. 14433) Establishes the Childhood Immunization Trust Fund for the entitlement program under the Public Health Service Act.