H.R.3545 - Omnibus Budget Reconciliation Act of 1987100th Congress (1987-1988)

Shown Here:
Conference report filed in House (12/21/1987)

Omnibus Budget Reconciliation Act of 1987 - Title I: Agriculture and Related Programs - Agricultural Reconciliation Act of 1987 - Subtitle A: Adjustments to Agricultural Commodity Programs - Amends the Agricultural Act of 1949 to set 1988 and 1989 target prices for: (1) wheat at $4.23 per bushel and $4.10 per bushel; (2) feed grains at $2.93 per bushel and $2.84 per bushel; (3) cotton at $0.759 per pound and $0.734 per pound; (4) extra long staple cotton at 118.3 per percent of the loan rate; and (5) rice at $11.15 per hundredweight and $10.80 per hundredweight.

Provides that: (1) 1988 loan rates for wheat, feed grains, rice, and cotton may not be reduced by more than three percent of the preceding year's level; and (2) 1989 loan rates for such crops may not be reduced by more than five percent of the preceding year's level, plus an additional two percent if the Secretary of Agriculture determines it necessary to maintain market competitiveness.

Directs the Secretary to implement a paid ten percent land diversion program for the 1988 and 1989 feed grain crops. States that: (1) the payment rate shall be $1.75 per bushel for corn, with other feed grain rates in relation to such rate; and (2) the Secretary may not implement such program if necessary to maintain an adequate commodity supply in 1989.

Directs the Secretary to reduce 1988 and 1989 tobacco by 1.4 percent through price support reductions or purchaser and producer assessments.

Directs the Secretary to reduce 1988 and 1989 peanut and sugar program costs by 1.4 percent.

Reduces honey loan levels by: (1) two cents per pound for 1987; (2) three-quarters cents per pound for 1988; (3) one-half cents per pound for 1989; and (4) one-quarter cents per pound for 1990.

Reduces 1988 milk prices by two and one-half cents per hundredweight.

Amends the National Wool Act of 1954 to set 1988 and 1989 wool and mohair price supports at 76.4 percent of the established support formula.

Limits 1988 through 1990 transportation loan rate differentials to not more than the national percentage rate plus or minus two percent.

Directs the Secretary to reduce FY 1988 and 1989 Commodity Credit Corporation storage costs by $230,000,000.

Prohibits the Secretary from establishing an acreage reduction program in excess of five percent for the 1988 through 1990 oat crops.

States that the minimum quantity of wheat and feed grains in the producer reserve program shall be 300,000,000 bushels and 450,000,000 bushels, respectively.

Requires the Secretary to make yield adjustment payments to 1988 through 1990 producers of wheat, feed grains, upland cotton, and rice if program payment yields are reduced by more than ten percent of 1985 levels.

Provides 1988 through 1990 advance deficiency payments for: (1) wheat and feed grains at between 40 percent and 50 percent of the projected payment rate; and (2) rice and upland cotton at between 30 percent and 50 percent of the projected payment rate.

Provides advance emergency compensation payments (75 percent ) for the 1987 through 1990 wheat crops.

Amends the Agricultural Adjustment Act of 1938 to: (1) permit, under specified circumstances, the lease and transfer of flue-cured tobacco quotas assigned to a farm after June 30 of any crop year; (2) repeal the required five-year yield factor adjustment for flue-cured tobacco; and (3) express the sense of the Congress that the Secretary should review current compliance procedures for acreage or poundage quotas with respect to cigar and dark-air and fire-cured tobaccos.

Amends the Agricultural Act of 1949 to permit haying and grazing as conservation use acreage under specified commodity adjustment programs except during any consecutive five-month period (between April 1 and October 31) as determined by the State agriculture committee. Authorizes the Secretary to: (1) permit unlimited haying and grazing in the case of a natural disaster; and (2) prohibit haying and grazing for economic reasons.

Subtitle B: Optional Acreage Diversion - Amends the Agricultural Act of 1949 to provide that producers of the 1988 through 1990 wheat and feed grain crops who devote all or a part of their permitted wheat or feed grain acreage to conservation or other authorized uses shall receive deficiency payments on the acreage considered to be planted to such crops.

Subtitle C: Farm Program Payments - Amends the Food Security Act of 1985 to provide that as of the 1989 crop year, a person who receives specified agricultural payments subject to limitations under such Act shall be prohibited from holding substantial beneficial interests (ten percent or more) in more than two corporations or entities that also receive such payments. (Permits a person who does not receive such payments to hold substantial interests in three entities.) Requires the Secretary to notify affected individuals and entities.

Limits agricultural payments to active farmers. Makes foreign persons ineligible for 1989 agricultural benefits.

Defines "person" for payment limitation purposes to include individuals, corporations, joint stock companies, associations, limited partnerships, charitable organizations, and States and their subdivisions and agencies.

Directs the Secretary to conduct payment provisions education for Department of Agriculture personnel.

Makes an individual who adopts a scheme or device to avoid payment limitations ineligible for agricultural benefits for such year and the succeeding year.

Repeals honey loan limitations.

Subtitle D: Rural Electrification Administration Programs - Chapter 1: Prepayment of Rural Electrification Loans - Permits FY 1988 prepayment of Federal Financing Bank loans by Rural Electrification Administration (REA) borrowers without penalty. Gives prepayment priority to specified borrowers who were already eligible, or who had begun prepayment, before enactment of this Act. Requires the Comptroller General to report to the Congress regarding such prepayments by January 1, 1989.

Permits a borrower of an insured or guaranteed electric loan to invest its own funds or make loans or guarantees of up to 15 percent of its total utility plant without prior REA approval.

Establishes a program to permit REA electric and telephone borrowers to make voluntary advance payments into cushion or credit accounts within the Rural Electrification and Telephone Revolving Fund. Sets interest rates at five percent. Permits a borrower to reduce such account balances only to make scheduled payments on loans made under such Act. Authorizes grants or zero interest loans to be made from such funds for rural economic development purposes.

Chapter 2: Rural Telephone Bank Borrowers - Permits FY 1988 prepayment of Rural Telephone Bank loans without penalty. Sets forth an interest rate formula. Establishes a telephone bank reserve fund. Requires the Comptroller General to report to the appropriate congressional committees regarding such prepayment program.

Subtitle E: Miscellaneous - Amends the Agricultural Adjustment Act of 1933 to authorize marketing order handler penalties.

Amends the Food Security Act of 1985 to extend the deadline for a commodity futures study from December 31, 1988, to December 31, 1989.

Amends the Agricultural Act of 1949 to authorize FY 1988 appropriations for technical assistance for the sale or barter of commodities to strengthen nonprofit private organizations in the Philippines.

Amends the Consolidated Farm and Rural Development Act to permit private nonprofit corporations to participate in rural industrialization grant programs.

Amends the Plant Variety Protection Act regarding plant variety protection fees to: (1) establish late payment penalties; (2) permit investment of funds; (3) authorize judicial action for nonpayment; and (4) authorize appropriations.

Amends Federal law to provide annual appropriations, beginning with FY 1988, to reimburse Commodity Credit Corporation net realized losses.

Expresses the sense of the Congress that in carrying out the Federal Crop Insurance Act, the Federal Crop Insurance Corporation: (1) should not be required to assume full loss adjustments; and (2) should assume and perform the loss adjustment obligations of a reinsured company if such company's loss adjustment performance and practices are not carried out in accordance with the applicable reinsurance agreement.

Expresses the sense of the Congress that the Administrator of the Environmental Protection Agency should use authority under the Clean Air Act to require greater use of ethanol as motor fuel.

Amends the Food Stamp Act of 1977 to authorize the State of Washington to carry out a Family Independence Demonstration Project as an alternative to providing benefits under the food stamp plan. Sets forth program provisions. Requires the Secretaries of Agriculture and of Health and Human Services to evaluate such program.

Title II: National Economic Commission - Establishes a National Economic Commission to make recommendations regarding: (1) methods to reduce the deficit while promoting economic growth and encouraging saving and capital formation; and (2) a means of ensuring that the burden of reducing the deficit does not undermine economic growth and is equitably distributed. Requires the Commission to submit its final report to the President and the Congress by March 1, 1989. Allows the President to extend such deadline. Terminates the Commission 30 days after submission of such report.

Title III: Education Programs - Subtitle A: Guaranteed Student Loan Program Savings - Amends the Higher Education Act of 1965 to require Federal recovery of excess cash reserves accumulated by guaranty agencies under the guaranteed student loan program. Prohibits guaranty agencies from accumulating cash reserves in excess of a specified amount. Directs the Secretary of Education (the Secretary, for purposes of this title) to recover such excess in various ways. Allows guaranty agencies to appeal and request a waiver of such recovery based on special circumstances. Sets a maximum limit on the total reduction of cash reserves which the Secretary may require for all guaranty agencies during FY 1988. Repeals these reduction and recovery of cash reserves provisions on September 30, 1989.

Requires (current law merely authorizes) guaranty agencies to furnish, upon request, to eligible institutions specified information on students who are delinquent or have defaulted on guaranteed student loans. Requires that such information include names and addresses of such students.

Subtitle B: Sale of College Facilities and Housing Loans - Prohibits the Secretary of Education, after September 30, 1988, from selling obligations held under the program for loans for construction, reconstruction, and renovation of academic facilities and the program for housing and other educational facilities loans. Includes as a violation of such prohibition any agreement providing for delaying payment or delivery or other actions furthering such sale until after such date.

Title IV: Medicare, Medicaid, and Other Health-Related Programs - Subtitle A: Medicare - Part 1: Relating Only to Part A: - Extends the reduction in Medicare payments under the President's sequestration order of November 20 1987, through March 31, 1988, for payments for inpatient hospital services and through December 31, 1987, for other items and services under part A (Hospital Insurance) of title XVIII (Medicare) of the Social Security Act.

Amends the Medicare program to increase hospital prospective payment rates by: (1) three percent for rural hospitals, 1.5 percent for hospitals located in large urban areas, and one percent for other hospitals for FY 1988; (2) the market basket percentage minus 1.5 percent for rural hospitals, the market basket percentage minus two percent for hospitals located in a large urban area, and the market basket percentage minus 2.5 percent for other hospitals for FY 1989; and (3) the market basket percentage for all hospitals thereafter. Sets payment rates for hospitals which are exempt from the prospective payment system.

Reduces payments to hospitals for indirect medical education costs. Increases payments to hospitals which serve a disproportionate share of low-income patients. Extends, through FY 1990, the adjustment of Medicare payments made to hospitals which serve a disproportionate share of low-income patients. Authorizes the Secretary of Health and Human Services, in certain circumstances, to treat one hospital facility of a multi-facility hospital as a disproportionate share hospital even if the hospital as a whole does not qualify as a disproportionate share hospital.

Requires the Secretary to regularly update the index representing the proportion of hospital costs attributable to wages on the basis of a survey of the wage-related costs of Medicare hospitals.

Treats certain hospitals which are located in a rural county which is adjacent to one or more urban areas as being urban hospitals for Medicare payment purposes.

Permits a rural hospital with less than 100 beds to furnish extended care services. (Currently, rural hospitals must have less than 50 beds to furnish such services.) Prohibits the making of Medicare payments to hospitals with more than 49 beds for extended care services: (1) which a patient receives after a bed has been available for five days in a skilled nursing facility located within the same region as the hospital, unless the patient's physician certifies that transferring the patient to such facility is medically inappropriate; and (2) to the extent such services utilize more than 15 percent of the bedspace over a cost reporting period.

Directs the Secretary of Health and Human Resources to report to the Congress by February 1989 concerning: (1) the proportion of hospital admissions for extended care services which are denied or approved by a peer review organization; and (2) methods of encouraging eligible hospitals that have a low occupancy rate and are located in areas in need of extended care service providers to enter into agreements with the Secretary to provide such services.

Extends, through FY 1990, the provision of additional payments to sole community hospitals experiencing a decrease of more than five percent in patient volume for a cost reporting period due to circumstances beyond their control. Requires the Secretary to report to the Congress by March 1, 1988, on the appropriateness of the criteria for designating hospitals as sole community hospitals. Allows a sole community hospital to qualify for such an adjustment without regard to the formula by which its Medicare payments are determined. Sets a cap on volume payment adjustments for FY 1988 and 1989.

Extends the Medicare classification of rural referral centers in include rural hospitals having more than 275 beds. (Currently, such hospitals must have more than 500 beds to be classified as rural referral centers.) Requires the Secretary to report to the Congress by March 1, 1989, on the criteria used for classifying hospitals as rural referral centers.

Directs the Secretary to establish a grant program to assist small rural hospitals and their communities plan and implement projects modifying the type and extent of services such hospitals provide in order to adjust to changes in the need for such services. Prohibits a grant to a hospital from exceeding a two-year term. Sets forth reporting requirements. Authorizes appropriations for FY 1989 and 1990.

Sets the amount by which a hospital's prospective payments shall be reduced to account for its capital-related costs at 12 percent of such payments for cost reporting periods occurring after January 1, 1988, and before the close of FY 1988, and at 15 percent of such payments for FY 1989. Requires that, after FY 1991, payments for such costs be made in accordance with a prospective payment system established by the Secretary. Directs the Prospective Payment Assessment Commission to report to the Congress by May 1, 1988, on the suitability and feasibility of linking payment for capitol-related costs to hospital occupancy rates.

Directs the Secretary to place into effect: (1) a data base of the operating costs of inpatient hospital services for all Medicare hospitals by June 1, 1989; (2) a standardized electronic hospital cost reporting format for cost reporting periods beginning on or after October 1, 1989; and (3) a three-year demonstration project in two States to develop, and determine the feasibility of establishing a uniform hospital reporting system. Directs the Comptroller General to conduct a study into the adequacy of the existing hospital reporting system and the costs and benefits of the system adopted under such demonstration project.

Prohibits the Secretary, from the date of this Act's enactment until 1989, from recouping, or otherwise reducing payments to Massachusetts hospitals for alleged overpayments made during the conduct of a specified demonstration project. Prohibits the Secretary from making any change in the policy in effect on August 1, 1987, regarding payments to providers for unrecovered costs.

Covers, from April 1, 1988, until October 1, 1989, 90 percent of the costs by which burn cases exceed the point at which a case is designated an outlier case. Prohibits changes in outlier payment regulations before September 1988. Requires the Prospective Payment Assessment Commission to conduct a study and report to the Congress and the Secretary by June 1, 1988, on the method of paying for outlier cases and providing more appropriate payments for burn outlier cases. Requires the Secretary to include in the annual Medicare report to the Congress a comparison of reductions and additional payments for outliers for urban and rural hospitals.

Sets forth miscellaneous and technical provisions.

Part 2: Provisions Relating to Parts A & B - Subpart A: Health Maintenance Organization Reforms - Requires health maintenance organizations (HMOs) to: (1) provide assurances to the Secretary that they will provide or arrange for supplementary Medicare coverage of enrollees (for up to six months) in the event the HMO terminates operations under Medicare; and (2) inform beneficiaries that the HMO's participation in Medicare might not be renewed or may be terminated, resulting in the termination of the beneficiaries' enrollment.

Repeals a provision of the Medicare program allowing direct Medicare payment of hospital and skilled nursing facility charges for which HMOs are liable.

Extends, from four to six years, the period during which an HMO may reserve additional payments in the Medicare trust funds for use in stabilizing subsequent fluctuations in the amount of such payments.

Imposes civil monetary penalties and intermediate sanctions on HMOs which: (1) fail substantially to provide medically necessary items and services if the failure adversely affects the enrollee; (2) charge an individual a greater premium than is permitted; (3) act to expel or refuse to re-enroll an individual for medical reasons; (4) engage in any practice that denies or discourages enrollment by individuals whose medical condition or history indicates a need for substantial future medical services; (5) misrepresent or falsify information; or (6) fail to make prompt claim payments.

Authorizes the Secretary to conduct capitation demonstration projects with HMOs and employer-related groups and projects testing alternative Medicare capitation payment methodologies.

Amends the Omnibus Budget Reconciliation Act of 1986 to delay from April 1, 1989, to April 1, 1990, the imposition of penalties against HMOs which make payments to physicians as an inducement to reduce or limit services to beneficiaries.

Directs the Comptroller General to conduct a study and submit a final report to the Congress by January 1, 1991, on Medicare capitation rates.

Waives the application of the requirement that at least one-half of an HMO's membership consist of individuals who are not entitled to Medicare or Medicaid (title XIX of the Act) benefits to: (1) certain HMOs which are a subdivision, subsidiary, or affiliate, of a parent HMO that satisfies membership requirements; and (2) a specified nonprofit corporation of Michigan which enrolls individuals with HMOs.

Amends the Deficit Reduction Act of 1984 to extend, through FY 1992, waivers for demonstrations of social HMOs which provide integrated health and social services on a prepaid capitated basis.

Amends the Omnibus Budget Reconciliation Act of 1986 to provide a temporary waiver of the Medicare requirement that HMOs must have an enrolled population of which not more than 50 percent are Medicare or Medicaid beneficiaries to HMOs which had a pre-existing waiver of such requirement and received specified grants in FY 1987.

Subpart B: Home Health Quality - Requires a Medicare home health agency to: (1) protect and promote the rights of each individual under its care; (2) notify the State licensing or certification entity of changes in persons having an ownership or control interest in the agency or changes in the organization responsible for managing the agency; (3) furnish items and services through licensed health care professionals or persons who have completed or are enrolled in a training or competency evaluation program which meets minimum standards to be established by the Secretary by October 1, 1988; (4) ensure that suppliers of durable medical equipment do not use individuals for the demonstration and use of such equipment who do not meet minimum training standards to be established by the Secretary by October 1, 1988; and (5) include the patient's plan of care within its clinical records.

Requires an appropriate State or local agency to conduct an unannounced survey on an average of once a year, but in no case later than 15 months after the previous unannounced survey, and within two months of the receipt of a significant number of complaints against a home health agency, of the quality of patient care provided by such agencies. Authorizes the survey of a home health agency within two months of any change in its ownership, administration, or management. Subjects home health agencies which perform poorly in such surveys to an extended survey. Directs the Secretary to evaluate the assessment process, report to the Congress on the results of such evaluation, and make appropriate modifications to such process by 1991.

Requires that when the Secretary determines that a home health agency's deficiencies immediately jeopardize the health and safety of service recipients the Secretary take immediate action to remove the jeopardy or correct the deficiencies, or terminate the agency's Medicare participation. Authorizes the Secretary to impose intermediate sanctions against an agency whose failure to correct deficiencies does not immediately jeopardize the health and safety of health care beneficiaries, but halts Medicare payments to such agency if six months pass without the correction of deficiencies.

Defines as "confined to his home", a prerequisite of eligibility for Medicare home health services, any person who has a condition which restricts his or her ability to leave the home without support or for whom leaving the home is medically contraindicated.

Requires appropriate State or local agencies to maintain: (1) toll-free hotlines to collect, maintain, and continually update information on Medicare home health agencies located in the State or locality and receive complaints and answer questions regarding such agencies; and (2) units with enforcement authority and access to consumer medical records (upon the consumer's consent) and survey reports to investigate such complaints.

Directs the Secretary to: (1) determine home health agency cost limits on the basis of the most recent audited wage data available from such agencies; (2) conduct a study and report to the Congress by June 1, 1988, regarding the appropriateness of adjusting home health agency cost limits to take into account differences in the costs of urban and rural home health agencies; and (3) establish a demonstration project to develop and test alternative methods of paying home health agencies on a prospective basis for services furnished under the Medicare and Medicaid programs.

Subpart C: Other Provisions - Prohibits Medicare claims from being processed within ten days in the final three months of FY 1988, and 14 days in FY 1989. Prohibits the Secretary from issuing, before FY 1991, any policy change primarly intended to delay Medicare claims processing.

Requires Medicare fiscal intermediaries which have denied a claim for home health or extended care services to: (1) furnish the provider and the individual with respect to whom the claim was made with a written explanation of the denial; and (2) promptly notify such individual and provider of the disposition of such reconsideration. Sets time limits on processing reconsiderations of claim denials for home health, extended care, and durable medical equipment services.

Amends title II (Old Age, Survivors, and Disability Insurance) (OASDI) of the Act to provide that when individuals become entitled to OASDI disability benefits by reason of a disability which previously entitled them to such benefits, both periods of entitlement shall count toward the two-year period of OASDI disability benefit entitlement required for Medicare eligibility despite and intervening period of gainful employment.

Amends the Omnibus Budget Reconciliation Act of 1986 to include government entities within the requirement that large group health plans function as the primary payer for items and services covered under such plans and the Medicare program.

Directs the Secretary to: (1) publish, by September 1 of each year, the data, standards, and methodology to be used to establish budgets for fiscal intermediaries and carriers for the upcoming fiscal year; (2) promulgate rules, requirements, and policy statements which establish or change a substantive legal standard governing benefits, payments, or eligibility through the regulatory process. Sets forth miscellaneous publication and information access provisions.

Makes a group health plan the primary payer for items and services covered under Medicare's end-stage renal disease program. Limits minimum utilization rate requirements for end-stage renal disease services to transplantations. Extends to July 1, 1988, the date by which guidelines for the reuse of bloodlines are required. (Currently, such guidelines must be established by January 1, 1988.) Requires the Secretary to arrange for a study of the end-stage renal disease program and report to the Congress regarding such study within three years of this Act's enactment.

Directs the Secretary and the Comptroller General to conduct a study and report to the Congress within six months of this Act's enactment on holding telephonic hearings on an individual's entitlement to Medicare benefits.

Directs the Secretary to enter into agreements with four hospitals to conduct three-year demonstration projects whereby such hospitals provide to rural hospitals, for one to three months of training, physicians who have completed one year of residency training.

Sets forth miscellaneous and technical provisions.

Part 3: Relating to Part B - Subpart A: Provisions Relating to Payments for Physicians's Services - Amends part B (Supplementary Medical Insurance) of the Medicare program to freeze the prevailing and customary charges for physicians' services in the first three months of 1988 at the level of such charges in 1987. Freezes the allowable actual charge for a nonparticipating physicians' services to Medicare beneficiaries for the first three months of 1988. Extends, to March 31, 1988: (1) Medicare participation agreements in effect on December 31, 1987, unless the physician or supplier requests that the agreement be terminated; and (2) the deadline for agreements to participate in Medicare in 1988. Requires the Secretary to establish a system to measure a carrier's performance. Sets aside one percent of appropriated part B administrative funds to reward carriers for increasing the proportion of participating physician or Medicare payments for participating physicians' services in their area. Extends the reduction in Medicare payments under the President's sequestration order of November 20, 1987, through March 31, 1988, for payments for physicians' services.

Increases the medical economic index for physicians services: (1) in 1988, by 3.6 percent for primary care services and one percent for other services; and (2) in 1989, by three percent for primary care services and one percent for other services.

Provides incentive payments to physicians who furnish services on an assignment-related basis in a rural area designated as a health manpower shortage area under the Public Health Service Act. Requires the Secretary to report to the Congress by January 1, 1990, on the feasibility of making additional payments for physicians' services performed in such areas.

Establishes a prevailing charge floor for primary care services.

Reduces the prevailing charge for bronchoscopy, carpol tunnel repair, cataract surgery, coronary artery bypass surgery, diagnostic and/or therapeutic dilation and curettage, knee arthroscopy, knee arthroplasty, pacemaker implantation surgery, total hip replacement, suprapubic prostatectomy, transurethral resection of the prostate, and upper gastrointestinal endoscopy. Limits nonparticipating physicians' actual charges for such procedures if such reductions in prevailing charges result in reductions in the reasonable charges for such procedures.

Prohibits the prevailing charge for ophthalmic ultrasound procedures from exceeding five percent of the prevailing charge for extracapsular cataract removal with lens implantation.

Prohibits the Secretary from setting the customary charge for a new physician's services at more than 80 percent of the prevailing charge for a service.

Reduces the rate of payment for a physicians provision of medical direction to nurse anethetists when such physician is providing medical direction to two or more nurse anethetists performing anesthesia services concurrently. Directs the Comptroller General to conduct two studies regarding payments for physician supervision of nurse anethetists.

Directs the Secretary to establish, and report to the Congress regarding fee schedules for radiologic services by August 1, 1988. Requires that such schedules take into account variations in the cost of furnishing services in different areas and result in certain reductions in aggregate Medicare payments for such services. Sets limits on the amount nonparticipating physicians may charge for such services.

Requires the Secretary to establish proposed fee schedules for physician pathology services which could be implemented by 1990 and report to the Congress regarding such fee schedules.

Prohibits a physician from charging more than the acquisition costs of a diagnostic test (other than a clinical diagnostic laboratory test) which such physician neither performed or supervised. Directs the Secretary to review prevailing charges for diagnostic tests and adjust those charges which are excessive.

Directs the Secretary to enter into an agreement with any physician who, by reason of breach of a contract entered into by such physician pursuant to the National Health Service Corps Scholarship Program, owes a past-due obligation to the United States under which deductions are to be made from amounts otherwise payable to the physician under the Medicare program until the past-due obligation has been repaid. Sets forth a procedure for collecting such amounts from providers and health maintenance organizations with whom such physicians are employed. Exempts physicians who are fulfilling such obligations under a contract with the Secretary pursuant to the Public Health Service Amendments of 1987 from such deductions.

Eliminates the 1975 floor on prevailing charges for physicians' services.

Bases the calculation of a physician's allowable actual charge for a procedure on such physician's actual charge for the procedure if the physician had such a charge prior to June 30, 1984, but not in the calendar quarter beginning on April 1, 1984.

Applies copayment and deductible requirements to outpatient surgical procedures furnished on an assignment-related basis.

Directs the Secretary to: (1) conduct various studies regarding Medicare payments for physicians' services; (2) develop uniform definitions of physicians' services by July 1, 1989; (3) expand a study being conducted on the development of a relative value scale for physicians' services to include specified additional physicians' services; (4) conduct a survey of the out-of-pocket costs incurred by Medicare beneficiaries for medical care; and (5) study ways of making adequate part B payments for the provision of chemotherapy in physicians' offices.

Subpart B: Provisions Relating to Payments for Other Services - Extends the reduction in Medicare payments under the President's sequestration order of November 20, 1987, through March 31, 1988, for payments for items and services under part B which are not physicians' services.

Prohibits the imposition of limitations on allowable charges in 1988 for part B items and services (other than physicians' services) which is higher than limitations in effect in December 1987.

Sets forth special Medicare payment rules for durable medical equipment, prosthetic devices, orthotics (leg, arm, back, and neck braces), and prosthetics. Authorizes the Secretary to designate one carrier to process all claims within a region for such items. Directs the Secretary to report to the Congress by 1991 on the impact of such rules on the availability of such items and the appropriateness of increasing payment rates for oxygen and oxygen equipment when a greater volume of oxygen or portable oxygen equipment is used. Prohibits the Secretary from conducting demonstration projects, before 1991, concerning alternative methods of paying for durable medical equipment, prosthetic devices, orthotics, and prosthetics. Requires the Comptroller General to conduct a study and report to the Congress by 1991 regarding the appropriateness of Medicare payment levels for such items.

Limits the reasonable charge for an intraocular lens implanted during cataract surgery in a physician's office or an ambulatory surgical center to the acquisition cost for the lens plus a handling fee.

Freezes the fee schedules for clinical diagnostic laboratory tests for the first three months of 1988. Prohibits cost-of-living increases in such fee schedules in 1988. Reduces the 1988 fee schedules for automated and similar tests by 8.3 percent. Sets the payment ceiling for a clinical laboratory diagnostic test at the median of all fee schedules established for that test for that setting. Requires the Comptroller General to conduct a study and report to the Congress by 1990 regarding the appropriateness of the fee schedules established for such tests. Authorizes the Secretary to impose intermediate sanctions on providers and clinical laboratories that fail to meet Medicare standards with respect to such tests. Treats physician office laboratories performing over 5,000 tests a year as independent laboratories which must meet State or local license requirements.

Prohibits regulations providing for payment of a return on equity capital from including provision for specific recognition of any return on equity capital with respect to hospital outpatient departments.

Sets a limit, determined pursuant to a specified formula, on the aggregate Medicare payment which may be made in a cost reporting period for the cost of outpatient diagnostic and outpatient hospital radiology services.

Sets the maximum rate of payment per visit for independent rural health clinic services at $46 in 1988, updated annually thereafter to reflect increases in the Medicare Economic Index. Requires the Secretary to report to the Congress by March 1, 1989, on the adequacy of payments for such services.

Maintains the current formula, in 1989 and 1990 for reimbursing hospitals which specialize in eye or eye and ear surgical procedures and receive over 30 percent of their revenues from outpatient procedures. Directs the Secretary to: (1) consider whether a payment differential for specialty hospitals is appropriate when studying the development of a prospective payment system for outpatient ambulatory surgery; and (2) solicit recommendations from the Prospective Payment Assessment Commission regarding such payment system and the model reimbursement system for non-surgical outpatient services, and include its recommendations in reports to the Congress.

Subpart C: Eligibility and Benefits Changes - Increases part B coverage of outpatient mental health services, but excludes from such coverage brief office visits for the sole purpose of prescribing or monitoring prescription drugs used in treating mental disorders. Provides part B coverage of partial hospitalization services furnished incident to physicians' outpatient services.

Provides Medicare coverage for influenza vaccines and their administration if the Secretary finds that a specified demonstration project proves such coverage to be cost-effective.

Covers therapeutic shoes furnished to individuals with severe diabetic foot disease, but conditions such coverage on its being proven cost-effective by a specified demonstration project.

Includes certified nurse-midwife services within covered part B services, but requires that payment for such services be made on an assignment-related basis.

Covers services furnished by a clinical social worker to a member of a health maintenance organization.

Limits covered immunosuppressive drugs to prescription drugs used in immunosuppressive therapy.

Provides coverage for the services of physician assistants in rural health manpower shortage areas.

Includes the services of clinical psychologists in the definition of covered rural health clinic services if such services would be covered if furnished by a physician or as an incident to a physician's services. Covers psychologists' services furnished at community health centers pursuant to a fee schedule to be established by the Secretary, but requires payments for such services to be made on an assignment-related basis.

Provides that here shall be no requirement that comprehensive outpatient rehabilitation facilities provide physical, occupational, or speech therapy at any fixed location so long as such services are delivered pursuant to a rehabilitation plan and payments are not otherwise made for the item or service under the Medicare program.

Directs the Secretary to enter into an agreement with no less than four eligible organizations for the provision of community nursing and ambulatory care on a prepaid, capitated basis for three years. Lists the services and supplies which comprise community nursing and ambulatory care. Defines an "eligible organization" as a public or private entity which: (1) primarily engages in the provision of community nursing and ambulatory care; (2) provides such care through or under the supervision of a registered nurse; (3) maintains clinical records on all patients; and (4) maintains procedures for referring cases to or consulting with other health care providers.

Requires the Secretary to annually publish a per capita rate of payment for each class of enrollees equal to 95 percent of the adjusted average per capita cost for such class. Directs the Secretary to make monthly prepayments to such organizations in accordance with such rates. Authorizes retroactive payment adjustments to account for differences between the actual number of enrollees and the number of enrollees estimated for the purpose of determining the advance payment. Prohibits enrollee charges from exceeding charges for which they would be liable in the absence of their enrollment.

Authorizes eligible organizations to provide enrollees with optional additional care. Requires the provision of additional care where the average of the per capita rates of payment to an organization exceeds the adjusted community rate for community nursing and ambulatory care, unless the organization elects to have such payments reduced or withheld.

Makes certain Medicare provisions which are applicable to health maintenance organizations and competitive medical plans applicable to organizations providing care pursuant to this Act.

Extends for one year, through 1989, current part B premium provisions.

Subpart D: Other Provisions - Directs the Secretary to establish a procedure whereby a part B beneficiary may assign his or her rights of payment under a Medicare supplemental health insurance policy for an item or service furnished by a participating physician or supplier so that such physician and supplier may be paid directly by the supplemental policy.

Requires the expedited administrative hearing of an appeal of a determination regarding an individual's entitlement to Medicare benefits or the amount of such benefits when there are no material issues of fact in dispute. Directs the Secretary to establish certain time limits on carriers' hearings regarding their Medicare payment determinations. Requires the Comptroller General to conduct a study and report to the Congress by June 30, 1989, regarding the cost-effectiveness of requiring a hearing before a carrier before having a hearing before an administrative law judge concerning a carrier's determinations under part B.

Requires that the Physician Payment Review Commission be composed of individuals with national recognition for their expertise in health economics, physician reimbursement, medical practice, and other related fields. Repeals the requirement that the Director of the Congressional Office of Technology Assessment seek nominations for such Commission. Treats employees of such Commission as employees of the United States Senate for purposes of pay and employment benefits, rights, and privileges.

Sets forth technical amendments related to certified registered nurse anesthetists.

Sets forth miscellaneous and technical provisions.

Part 4: Peer Review Organizations - Amends part B (Peer Review) of title XI of the Act to provide that the Secretary's contracts with peer review organizations (PROs) shall be for an initial three-year term and be renewable on a triennial basis thereafter.

Requires the Secretary to publish in the Federal Register: (1) any new policy or procedure which substantially affects PRO performance of contract obligations within 30 days prior to the effective date of such policy or procedure; and (2) the general criteria and standards used in evaluating PRO performance of contract obligations. Directs the Secretary to: (1) regularly furnish each PRO with a report that documents its performance in relation to other PROs; and (2) negotiate necessary contractual modifications with PROs before requiring them to perform additional functions.

Requires the Secretary to publish in the Federal Register, no later than six months before a contract with an out-of-State PRO expires, notice as to the date the existing contract expires and the period during which an in-State organization may submit a contract proposal. Provides that if one or more in-State organizations submit a proposal the new contract shall be awarded on a competitive basis.

Requires PROs to give providers whose services are denied Medicare coverage an opportunity for discussion and review of the determination for 20 days before patients and organizations responsible for paying claims are notified of such determination.

Requires PROs to: (1) consider, in developing norms of care, the special problems associated with delivering care in remote rural areas, the availability of service alternatives to inpatient hospitalization, and other appropriate factors that could adversely affect the safety or effectiveness of outpatient treatment; (2) perform significant on-site review activities, including on-site review at at least 20 percent of the rural hospitals in its area; (3) offer to provide, several times each year, for a physician representative of the PRO to meet with the staff of each hospital regarding the PRO's review of the hospital's Medicare services; (4) publish and distribute to providers and practitioners, at least annually, a report describing the PRO's findings with respect to situations in which the PRO has frequently found medical care to be inadequate or unnecessary; (5) determine whether individuals enrolled with an HMO have adequate access to services provided by or through such HMO; (6) apprise HMO enrollees regarding the peer review system and the method of contacting the PRO; and (7) make arrangements for the initial review of psychiatric and physical rehabilitation services to be made by a physician who is trained in psychiatry or physical rehabilitation. Directs the Secretary, when evaluating the performance of PROs, to emphasize the performance of PROs in educating providers and practitioners (particularly those in rural areas) concerning the review process and criteria being applied by the PRO. Requires the Secretary to establish demonstration projects examining the feasibility of requiring instruction and oversight of rural physicians, in lieu of imposing sanctions, through the use of video communication between rural and teaching hospitals.

Prohibits the Medicare exclusion of a provider located in a rural health manpower shortage area or in a county with a population of less than 70,000 pending completion of administrative review procedures unless a hearing before an administrative law judge results in the determination that the provider or practitioner will pose a serious risk to beneficiaries if allowed to continue furnishing Medicare services.

Directs the Secretary to report to the Congress, within one year of this Act's enactment, on improved procedures for imposing sanctions against Medicare providers which furnish items or services that are not medically necessary or do not meet professionally recognized health care standards.

Amends part B of the Medicare program to protect Medicare beneficiaries from liability for services which PROs determine are not covered under the Medicare program.

Amends part B of title XI to require a hospital to notify a patient of its request that a PRO review its determination that such patient no longer requires inpatient hospital care if the attending physician disagrees with the hospital's determination.

Amends the Medicare program to require that the Secretary's budget separately state the amount of budget authority for inpatient hospital services and the amount of budget authority for the PRO program. (Currently, PRO costs are included as costs incurred by hospitals in providing inpatient hospital services.)

Subtitle B: Medicaid - Part 1: Eligibility and Benefits - Amends title XIX (Medicaid) of the Act to allow States to extend Medicaid coverage to pregnant women and infants under age one whose family income exceeds current income eligibility standards, but does not exceed 185 percent of the Federal poverty level.

Authorizes States to accelerate the coverage of poor children under age five. (Currently, coverage would not be extended to all poor children under age five until FY 1991.) Requires the coverage of children under age six. Allows States to extend Medicaid coverage to poor children under age eight.

Authorizes States to impose a premium for the coverage of pregnant women and infants, but limits such premium to ten percent of the amount by which the family's income, minus child care expenses, exceeds 150 percent of the Federal poverty level.

Requires a State, under a home or community-based waiver, to cover home or community-based services provided pursuant to a written plan of care to individuals age 65 or older with respect to whom there has been a determination that but for the provision of such services the individuals would require the level of care provided in a skilled nursing or intermediate care facility, the cost of which could be reimbursed under the Medicaid program. Provides that such a waiver shall be for an initial three-year term and, upon a State's request, for additional five-year terms. Sets funding limitations. Requires the Secretary to develop methods of projecting increases in nursing facility and home care costs, and the percentage increase in the number of residents in each State who are 75 or older. Specifies that the Secretary's denial of such a waiver shall be subject to administrative and judicial review and an existing waiver shall remain in effect for 90 days after its extension is denied.

Authorizes States to apply for the temporary extension of certain waivers for the elderly which are due to expire before July 1, 1988.

Provides Medicaid coverage of medical and surgical services furnished by a dentist to the extent State law permits the provision of such services by both dentists and physicians.

Authorizes certain States to provide Medicaid coverage of individuals who receive only an optional State supplementary payment based on need.

Clarifies the inclusion of services furnished by clinic personnel to the homeless outside the clinic within covered Medicaid clinic services.

Authorizes California to set a special Medicaid income eligibility level for a family of two individuals both of whom are adults and at least one of whom is aged, blind, or disabled.

Part 2: Other Provisions - Amends part A (General Provisions) of title XI of the Act to increase the maximum amount of annual Medicaid payments that may be made to Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa.

Requires each State to specify which hospitals in the State serve a disproportionate number of low-income patients with special needs and increase the rate or amount of Medicaid payments for such services. Sets forth the criteria for determining whether a hospital serves a disproportionate share of low-income patients, including the requirement that such hospitals have at least two obstetricians on staff who have agreed to serve Medicaid beneficiaries.

Amends the Medicaid program to authorize the New Jersey Medicaid agency to establish a program providing health care on a prepaid basis through a separate entity (including a subdivision of the State Medicaid agency) responsible for the operation of such program in accordance with HMO requirements.

Sets the Federal Medicaid matching rate for quality review of HMO services by a private accreditation body at 75 percent.

Prohibits the enrollment of an individual in a primary care case-management system, an HMO, or a similar entity from restricting that individual's freedom of choice among family planning providers.

Makes provisions which protect an HMO enrollee's Medicaid eligibility and restricts his or her disenrollment without cause applicable to the Metropolitan Health Plan HMO operated by the New York City public hospitals.

Waives restrictions imposed on inpatient care for Medicaid hospice patients in the case of individuals afflicted with acquired immunodeficiency syndrome (AIDS).

Extends, through September 1989, an Arizona demonstration project providing Medicaid services on a prepaid basis.

Authorizes New York State, upon the Secretary's approval, to conduct a three-year demonstration project testing its Prenatal/Maternity/Newborn Care Pilot Program as an alternative to existing Federal programs.

Directs the Secretary to waive the application of certain Medicaid requirements with respect to Washington State's Family Independence Program upon such program's approval.

Authorizes the Secretary to waive or modify Medicaid requirements with respect to the Northern Mariana Islands.

Prohibits the Secretary from reducing, prior to July 1, 1988, Medicaid payments to States having high erroneous payment rates.

Sets forth miscellaneous and technical amendments.

Subtitle C: Nursing Home Reform - Part 1: Medicare Program - Amends the Medicare program to set forth requirements for skilled nursing facilities (other than facilities for the mentally retarded), including requirements that such facilities: (1) primarily engage in providing residents with nursing care or rehabilitation services directed toward residents' mental, psychosocial, and physical well-being; (2) maintain a quality assessment and assurance committee which meets at least quarterly to identify areas where quality assessment and assurance is necessary and implement plans to correct deficiencies; (3) provide such care in accordance with a written plan of care initially prepared and periodically reviewed and revised, by a team which includes the attending physician and a professional registered nurse, on the basis of assessments of a resident's functional capacity conducted upon the resident's admission and after a significant change in the resident's physical or mental condition, but in no case less often than annually; (4) provide, in addition to nursing and rehabilitative services, such physicians' services, medically-related social services, pharmaceutical services, dietician services, and dental services as are required to fulfill each resident's plan of care; (5) require nurse aides who are not licensed health professionals to complete a State-approved training or retraining program before participating in resident care, and have an ongoing program of nurse aide training and performance review; (6) require a physician's supervision of each resident's care, the maintenance of clinical records on all residents, and 24-hour nursing services; (7) protect specified resident rights, including the right to appeal a transfer or discharge from the facility; (8) safeguard a resident's funds upon the resident's authorization; (9) notify the State agency responsible for licensing the facility of changes in the ownership, control, or administration of the facility; (10) adopt certain measures to preserve facility safety and sanitation; and (11) meet such other conditions which the Secretary deems necessary for residents' health and safety. Subjects individuals who participate in the falsification of resident assessments to civil money penalties.

Requires States, by March 1, 1989, to: (1) specify State-approved nurse aide training and testing programs which meet minimum standards to be established by the Secretary by September 1, 1988; and (2) maintain a registry of nurse aides who have successfully completed such programs, including specific findings of resident neglect or abuse or misappropriation of resident property involving such individuals. Prohibits State approval of a training program offered by a facility that has been out of compliance with the Act's requirements within the preceding two years. Requires States to: (1) establish a fair mechanism which meets Federal guidelines to be established by October 1, 1989, for hearing appeals on transfers of residents from nursing facilities; and (2) implement and enforce standards which are to be developed by the Secretary by March 1, 1989, regarding the qualifications of nursing facility administrators.

Requires the Secretary to publish a list of the costs which may be charged to the personal funds of residents who are covered by Medicare. Reimburses nursing facilities for the reasonable costs of complying with this Act's requirements. Directs the Secretary to report to the Congress by January 1, 1992, on the implementation of the nursing facility resident assessment process.

Requires States to conduct periodic educational programs for the staff and residents of nursing facilities on current regulations, procedures, and policies concerning the quality of care provided at such facilities. Requires States to establish a process for the receipt, review, and investigation of allegations of resident neglect and abuse, and misappropriation of resident property by a nurse aide in a nursing facility. Makes the Secretary responsible for certifying that State nursing facilities comply, and States responsible for certifying that other nursing facilities comply with Medicare nursing facility requirements. Bases such certifications on standard surveys to be conducted within two months of any change in the ownership or administration of such a facility and, on an unannounced basis, at least every 15 months. Prohibits the Statewide average interval between surveys from exceeding one year. Subjects facilities which were found to have provided substandard care to extended surveys.

Requires that surveys be conducted by a multidisciplinary team of professionals who have successfully completed a training and testing program approved by the Secretary.

Directs the Secretary to: (1) develop and test a protocol for conducting surveys; (2) establish minimum qualifications for surveyors; and (3) conduct sample surveys of nursing facilities, within two months of State surveys, to test the adequacy of State surveys, and, if the State surveys prove inadequate, provide for an appropriate remedy, which may include training survey teams in the State. Authorizes the Secretary to conduct a special survey of a facility when there is reason to question its compliance with this Act.

Requires States to investigate complaints against, and monitor the compliance of, a facility with this Act's requirements if the facility was previously found to be out of compliance with such requirements or the State has reason to question its compliance. Authorizes States to use a specialized team to gather and survey evidence and carry out enforcement actions against chronically substandard facilities.

Requires that certain information regarding nursing facilities and their compliance with this Act's requirements be made available to the public. Provides long-term care ombudsmen, resident's physicians, and the State board which licenses facility administrators with notice of a facility's poor quality of care. Gives State Medicaid (title XIX of the Act) fraud and abuse control units access to facility survey and certification information. Requires that survey results be posted in a place which is readily accessible to residents and their representatives.

Requires the Secretary or a State to recommend the Secretary to terminate a nursing facility's Medicare participation or take immediate action to remove the jeopardy and correct the deficiencies through the appointment of temporary management to oversee the operation of the facility and assure residents' health and safety upon determining that such deficiencies immediately jeopardize residents' health and safety. Authorizes States to recommend certain other remedies where the health and safety of facility residents is not immediately jeopardized. Provides that if a facility is found out of compliance with any of this Act's requirements three months after having been found out of compliance with such requirements or to have provided substandard care on three consecutive surveys, Medicare payments for newly admitted residents shall be denied and, in the latter case, on-site monitoring of the facility's compliance shall be established.

Requires the Secretary to report to the Congress annually on nursing facility compliance with Medicare requirements and the number and type of enforcement actions taken against such facilities.

Part 2: Medicaid Program - Amends the Medicaid program to establish a single set of requirements for skilled nursing and intermediate care facilities (other than facilities for the mentally retarded), and to refer to such facilities as "nursing facilities." Sets forth requirements for nursing facilities, including requirements that such facilities: (1) primarily engage in providing residents with nursing care, rehabilitative services, and other health-related services which can only be provided through such facilities, directed toward residents' mental, psychosocial, and physical well-being; (2) maintain a quality assessment and assurance committee which meets at least quarterly to identify areas where quality assessment and assurance is necessary and implement plans to correct deficiencies; (3) provide such care in accordance with a written plan of care initially prepared and periodically reviewed and revised, by a team which includes the attending physician and a professional registered nurse on the basis of assessments of a resident's functional capacity conducted upon the resident 's admission and after a significant change in the resident's physical or mental condition, but in no case less often than annually; (4) provide, in addition to nursing and rehabilitative services, such physicians' services, medically-related social services, pharmaceutical services, dietician services, and dental services as are required to fulfill each resident's plan of care; (5) require nurse aides who are not licensed health professionals to complete a State-approved training or retraining program before participating in resident care, and have an ongoing program of nurse aide training and performance review; (6) require a physician's supervision of each patient's care, the maintenance of clinical records on all patients, and, with certain exceptions, the services of a licensed nurse 24 hours a day and a registered nurse eight hours a day; (7) employ a full-time social worker if they have over 120 beds; (8) protect specified patient rights, including the right to appeal involuntary transfer or discharge from the facility; (9) provide applicants and residents with information regarding the Medicare and Medicaid programs and not require applicants to waive their rights to such benefits, have a third party guarantee payment to the facility, or charge a Medicaid beneficiary more than is required to be paid under the Medicaid program as a condition of their admission; (10) safeguard a resident's funds upon the resident's authorization; (11) not admit any new resident, after 1988, who is mentally ill or retarded unless the State mental health authority deems such individual to require nursing facility services and decides whether the individual requires active treatment for mental illness or retardation; (12) notify the agency responsible for licensing the facility of changes in the ownership, control, or administration of the facility; (13) adopt certain measures to preserve facility safety and sanitation; and (14) meet such other conditions which the Secretary deems necessary for patient health and safety.

Requires States to specify, by September 1, 1988, those nurse aide training programs which meet the minimum standards to be established by the Secretary by July 1, 1988, and have the State's approval. Prohibits State approval of a training program offered by a facility that has been out of compliance with this Act's requirements within the previous two years. Requires each State to: (1) establish a registry, by 1989, of all individuals who have satisfactorily completed a nurse aide training program in the State, including specific findings of resident neglect or abuse or misappropriation of resident property involving such individuals; (2) develop a written notice, by April 1988, of the rights and obligations of nursing facility residents under the Medicaid program; (3) establish a fair mechanism, by October 1, 1989, which meets Federal guidelines to be established by October 1, 1988, for hearing appeals on transfers of residents from nursing facilities; and (4) implement and enforce standards which are to be developed by the Secretary by March 1, 1988, regarding the qualifications of nursing facility administrators.

Requires that, in addition to the preadmission review of mentally ill or retarded individuals, State mental health authorities conduct an annual review of mentally ill or retarded residents to determine whether such residents require nursing facility services and whether they require active treatment for mental illness or retardation. Directs that such preadmission and annual reviews be conducted in accordance with criteria to be developed by the Secretary by October 1, 1988. Sets forth required nursing facility responses to determinations as to whether such residents need nursing facility services and need, or do not need, active treatment for mental illness or retardation. Gives long-term residents who do not require nursing facility services, but who require active treatment, the choice of remaining in the facility or receiving covered services in an alternative setting. Require's nursing facilities to provide for the active treatment of residents in need of treatment for mental illness or retardation regardless of their continued need for nursing facility services or their dishcarge from such facility. Requires States to have an appeals process for individuals adversely affected by such preadmission and annual reviews.

Directs the Secretary to publish a list of the costs which may be charged to the personal funds of residents who are covered by Medicaid.

Requires the Secretary to report to the Congress by 1993 on the implementation of the resident assessment process. Imposes civil monetary penalties on individuals who falsify resident assessments.

Sets the Federal matching percentage for: (1) nurse aide training and testing programs at the Federal medical assistance percentage plus 25 percent, but not exceeding 90 percent, for FYs 1988 and 1989, and at 50 percent thereafter; and (2) preadmission and annual screening of mentally ill or retarded residents at 75 percent.

Directs the Secretary to: (1) provide States with technical assistance in the development and implementation of reimbursement methods for nursing facilities that take into account the case mix of residents in different facilities; and (2) report to the Congress by January 1, 1993, on the progress made in implementing this Act's nursing facility staffing requirements.

Requires States to conduct periodic educational programs for the staff and residents of nursing facilities on current regulations, procedures, and policies concerning the quality of care provided at such facilities. Requires States to establish a process for the receipt, review, and investigation of allegations of resident neglect and abuse, and misappropriation of resident property by a nurse aide in a nursing facility. Makes the Secretary responsible for certifying that State nursing facilities comply, and States responsible for certifying that other nursing facilities comply with Medicaid nursing facility requirements. Bases such certifications on standard surveys to be conducted within two months of any change in the ownership or administration of such a facility and, on an unannounced basis, at least every 15 months. Prohibits the Statewide average interval between surveys from exceeding one year. Subjects facilities which were found to have provided substandard care to extended surveys.

Requires that surveys be conducted by a multidisciplinary team of professional who have successfully completed a training and testing program approved by the Secretary.

Directs the Secretary to: (1) develop and test a protocol for conducting surveys; (2) establish minimum qualifications for surveyors; (3) conduct sample surveys of nursing facilities, within two months of State surveys, to test the adequacy of State surveys; and (4) reduce Federal payments for State Medicaid administrative costs if State surveys prove inadequate. Authorizes the Secretary to conduct a special survey of a facility when there is reason to question its compliance with this Act.

Requires States to investigate complaints against, and monitor the compliance of, a facility with this Act's requirements if the facility was previously found to be out of compliance with such requirements or the State has reason to question its compliance. Authorizes States to use a specialized team to gather and survey evidence and carry out enforcement actions against chronically substandard facilities.

Requires that certain information regarding nursing facilities and their compliance with this Act's requirements be made available to the public. Provides long-term care ombudsmen, residents' physicians, and the State board which licenses facility administrators with notice of a facility's poor quality of care. Gives State Medicaid (title XIX of the Act) fraud and abuse control units access to facility survey and certification information. Requires that survey results be posted in a place which is readily accessible to residents and their representatives.

Sets the Federal matching percentage for nursing facility certification activities at 90 percent in FY 1991, 85 percent in FY 1992, 80 percent in FY 1993, and 75 percent thereafter.

Eliminates current penalties applied to a State when its control over the utilization of skilled nursing or intermediate care facility services is deemed inadequate. Requires that when the Secretary or a State determines that a nursing facility's deficiencies immediately jeopardize residents' health and safety, immediate action be taken to remove the jeopardy and correct the deficiencies or such facility's participation in Medicaid be terminated. Directs the Secretary and States to apply certain other remedies where the health and safety of facility residents is not immediately jeopardized. Authorizes the imposition of civil money penalties against facilities found to be in compliance with this Act's requirements but to have been out of compliance previously. Provides that if a facility is out of compliance with any of this Act's requirements three months after having been found out of compliance with such requirements or on three consecutive standard surveys, Medicaid payments for newly admitted residents shall be denied and, in the latter case, on-site monitoring of the facility's compliance shall be established. Authorizes each State to establish a program providing rewards to facilities providing the highest quality of care. Sets forth special rules which are to be applied where a State and the Secretary do not agree on a finding of noncompliance or the remedies which should be prescribed.

Requires the Secretary to report to the Congress annually on nursing facility compliance with Medicaid requirements and the number and type of enforcement actions taken against such facilities.

Directs the Secretary, within 30 days of this Act's enactment, to promulgate final regulations required by the Omnibus Budget Reconciliation Act of 1985 regarding State submittal of correction and reduction plans for intermediate care facilities for the mentally retarded which have deficiencies that do not immediately jeopardize residents' health and safety.

Authorizes a nurse practitioner or clinical nurse specialist, in collaboration with a physician, to certify and recertify a patient's need for skilled nursing or intermediate care facility services.

Subtitle D: Vaccine Compensation - Vaccine Compensation Amendments of 1987 - Amends the Public Health Service Act to provide that payment of compensation for an injury or death from administration of a vaccine before the effective date of this provision shall be made from specified appropriations and that compensation for injury or death from administration on or after the effective date shall be made from the Vaccine Injury Compensation Trust Fund. Authorizes appropriations for FY 1989 through 1992.

Removes provisions: (1) placing limitations on the amount of unreimbursable expenses which may be recovered; (2) requiring payments for projected expenses to be paid on a periodic basis; and (3) allowing payments for paid and suffering, emotional distress, and incurred expenses to be paid in a lump sum. Requires compensation for injury or death from administration of a vaccine on or after the effective date to be paid in a lump sum and payment for injury or death from administration before the effective date to be made in four annual installments.

Repeals provisions relating to administration by the National Vaccine Injury Compensation Program (Program) of awards and relating to revision of awards. Repeals a provision relating to annual inflation increases for certain compensation and for civil penalties.

Revises provisions relating to compensation for injury or death from administration of a vaccine before the effective date to change the categories for which compensation is prohibited and allowed and to limit specified types of compensation under certain categories to a stated amount.

Directs the Secretary of Health and Human Services to review the number of awards in specified periods and, if the Secretary determines that the number exceeds the number of awards listed in a specified table, to notify the Congress of the determination. Prohibits, in such case, the filing of a petition after a stated period. Makes specified provisions relating to the filing of petitions and relating to additional remedies inapplicable to civil actions for damages for a vaccine-related injury or death for which a petition may not be filed because of such prohibition.

Revises provisions relating to petitions for compensation.

Allows withdrawal of a petition on which a court has failed to enter a judgment within a specified time. Allows, after withdrawal, maintenance of a civil action for damages.

Authorizes awarding of costs of litigation to any plaintiff in certain circumstances in a citizen action against the Secretary for failure to perform under the National Vaccine Program subtitle. (Current law authorizes awarding of costs to any party when appropriate.)

Makes general rules relating to petitions for compensation apply to those who administer as well as those who manufacture a vaccine.

Grants jurisdiction over matters involving vaccine injury compensation to the U.S. Claims Court.

Removes provisions authorizing a court to refer a record of a proceeding, after entry of a final judgment providing for compensation, to the Secretary of Health and Human Services and the Attorney General with respect to a civil action by the Secretary under provisions relating to subrogation.

Subtitle E: Rural Health - Amends title VII (Administration) of the Social Security Act to establish an Office of Rural Health Policy in the Department of Health and Human Services to: (1) advise the Secretary regarding the effects of changes in the Medicare and Medicaid programs on rural health care; (2) oversee compliance with provisions of this Act requiring regulatory impact analyses and rural health demonstration projects; (3) establish and maintain a clearinghouse for collecting and disseminating information on rural health care; (4) coordinate rural health care activities within the Department of Health and Human Services; and (5) provide the Department with information regarding the rural health care activities of other Federal departments and agencies.

Amends part A (General Provisions) of title XI of the Act to require that whenever the Secretary of Health and Human Services proposes a regulation or promulgates a final version of a regulation under titles XVIII (Medicare), XIX (Medicaid), or part B (Peer Review) of title XI of the Act which will have a substantial impact on small rural hospitals, the Secretary make a regulatory impact analysis available to the public.

Sets aside ten percent of amounts expended by the Secretary on certain experiments and demonstration projects relating exclusively or substantially to rural health issues.

Title V: Energy and Environment Programs - Subtitle A: Nuclear Waste Amendments - Nuclear Waste Policy Amendments Act of 1987 - Part A: Redirection of the Nuclear Waste Program - Amends the Nuclear Waste Policy Act of 1982 to direct the Secretary of Energy (the Secretary) to provide for an orderly phase-out of site-specific activities at all candidate sites other than the Yucca Mountain site (Nevada); and (2) terminate all site specific activities other than reclamation activities at all other candidate sites. Declares the State of Nevada eligible to enter into a benefits agreement with the Secretary. Prescribes the termination procedure for the Secretary to follow if he should determine that the Yucca Mountain site is unsuitable for repository development. States that for purposes of the Environmental Policy Act and related environmental concerns the Secretary and the Nuclear Regulatory Commission need not consider alternate sites to the Yucca Mountain repository or nongeologic alternatives to such site.

Prohibits the Secretary from conducting site-specific activities regarding a second repository unless the Congress has specifically authorized and appropriated funds for such activities. Requires the Secretary to: (1) report to the President and the Congress by January 1, 2010, on the need for a second repository; and (2) phase-out all funding for research programs regarding crystalline rock suitability as a potential repository host medium within a specified deadline. Prescribes additional criteria for the Secretary's mandatory consideration if potential crystalline rock sites are considered in the future.

Part B: Monitored Retrievable Storage - Annulls and revokes the Secretary's proposal to locate a monitored retrievable storage (MRS) facility on the Clinch River in Oak Ridge, Tennessee (including an alternate site in Hartsville, Tennessee). Authorizes the Secretary to site, construct and operate one MRS facility subject to a report and recommendation transmitted to the Congress by the Monitored Retrievable Storage Review Commission (established by this Act.)

Establishes such Commission (Commission) and requires it to report on the need for an MRS facility as part of a national nuclear waste management system. Prescribes the contents of such report and mandates its transmittal to the Congress by June 1, 1989.

Authorizes the Secretary to survey and evaluate potentially suitable MRS sites after the Commission has submitted its report. States that the Secretary's site selection and site-specific activities shall not require an environmental impact statement under the National Environmental Policy Act of 1969. Requires the Secretary to submit an environmental assessment to the Congress at the time of site selection. Proscribes the construction of an MRS facility in the State of Nevada. Sets forth disapproval procedures and benefits for affected States and Indian tribes.

Sets forth environmental assessment requirements and licensing conditions once selection of an MRS site is effective.

Part C: Benefits - Authorizes the Secretary to enter into a benefits agreement with the State of Nevada concerning a repository, or with an affected State or Indian tribe concerning an MRS facility. Prescribes guidelines for such agreements, including the mandatory establishment of a Review Panel to advise, evaluate and participate in facility design, construction, operation and decommissioning. Sets forth guidelines for the termination of such agreements.

Requires the Secretary, in siting Federal research projects, to: (1) give special consideration to proposals from States where a repository is located; (2) report to the Congress within one year of enactment of this Act regarding specified potential impacts of locating a repository at the Yucca Mountain site; and (3) make grants and provide technical and financial assistance to the State of Nevada (and affected local governments). Prohibits any State, other than the State of Nevada, from receiving financial assistance for repository siting purposes after the date of enactment of this Act.

Part D: Nuclear Waste Negotiator - Establishes within the Executive Office of the President the Office of the Nuclear Waste Negotiator, headed by the Nuclear Waste Negotiator who shall be appointed by, and hold office at the pleasure of, the President (with the advice and consent of the Senate). Requires the Negotiator to: (1) find a State or Indian tribe willing to host a repository (or monitored retrievable storage site (MRS)); and (2) submit to the Congress any proposed agreement regarding such repository host. Directs the Secretary, upon the Negotiator's request, to prepare an environmental assessment of any site that is under negotiation. Prescribes guidelines for environmental assessments and site characterization. Authorizes grants to assess the feasibility of siting an MRS within the affected locality.

Declares that the issuance of a repository construction authorization shall be considered a major Federal action under the National Environmental Policy Act of 1969 (thus requiring the Secretary of Energy to prepare a final environmental impact statement).

Sets forth a termination date for the Office. Authorizes appropriations.

Part E: Nuclear Waste Technical Review Board - Establishes the Nuclear Waste Technical Review Board as an independent entity within the executive branch to evaluate the Secretary's activities, including site characterization and the packaging and transportation of radioactive waste. Outlines the Board's membership, terms of office, and administrative parameters.

Requires the Board to report its findings and recommendations biannually to the Congress and the Secretary. Authorizes appropriations. Terminates such Board within one year after the date on which the Secretary begins repository disposal of high-level radioactive waste or spent nuclear fuel.

Part F: Miscellaneous - Prohibits the transportation of spent nuclear fuel or high-level radioactive waste by or for the Secretary except in packages that have been certified for such purpose by the Nuclear Regulatory Commission. Directs the Secretary to: (1) abide by the Commission's regulations regarding advance notification of State and local governments prior to transportation of spent nuclear fuel or high-level radioactive waste; and (2) provide States with technical assistance and funds for training public safety officials through whose jurisdiction the Secretary plans to transport radioactive materials.

Prohibits the air transportation of plutonium through U.S. air space from a foreign nation to a foreign nation unless the NRC has certified to the Congress that the plutonium container is safe according to specified criteria. Authorizes the President to provide for alternative plutonium transportation routes with respect to shipments among foreign nations which are subject to certain U.S. consent rights contained in an "Agreement for Peaceful Nuclear Cooperation." Exempts certain medical and military uses from such proscription, as well as plutonium shipment containers previously certified as safe by the NRC. Provides for reimbursement of NRC testing and administrative expenditures by the foreign country receiving plutonium through U.S. airspace.

Directs the Secretary to report to the Congress on subseabed disposal of spent nuclear fuel and high-level radioactive waste. Prescribes the contents of such report.

Establishes an Office of Subseabed Disposal Research within the Office of Energy Research of the Department of Energy, headed by a Director responsible for research, development, and demonstration activities regarding subseabed disposal of high-level radioactive waste and spent nuclear fuel.

Directs the Secretary to establish a university-based Seabed Consortium composed of oceanographic universities and institutions to investigate the technical and institutional feasibility of subseabed disposal. Requires the Consortium to report to the Congress regarding the design, costs, and impacts of a subseabed disposal system. Requires the Director of the Office of Subseabed Disposal Research to report annually to the Congress regarding Office activities. Provides funding.

Sets a time-frame within which the Secretary must study and evaluate the use of dry cask storage technology at civilian nuclear power reactor sites for the temporary storage of spent nuclear fuel until a permanent geologic repository is operative for such purpose. Prescribes the contents of such study and directs the Secretary to report on it to the Congress by October 1, 1988.

Subtitle B: Federal Onshore Oil and Gas Leasing Reform Act of 1987 - Federal Onshore Oil and Gas Leasing Reform Act of 1987 - Amends the Mineral Lands Leasing Act of 1920 regarding competitive leasing of oil and gas for onshore Federal lands to increase from 640 acres to 2,560 acres the units of land open to competitive leasing. Restricts the maximum units in Alaska to 5,760 acres.

Provides for lease sales to be: (1) conducted by oral bidding; and (2) held at least quarterly in each State (or more frequently at the Secretary of the Interior's discretion). Conditions such lease sales upon the payment of specified royalties.

Requires the Secretary to accept the highest bid from a responsible qualified bidder which is equal to or greater than the national minimum acceptable bid. Mandates rejection of all bids for less than the national minimum acceptable bid. Declares that the national minimum acceptable bid shall be $2.00 per acre for a period of two years from the date of enactment of this Act. Authorizes the Secretary to establish a higher national minimum acceptable bid thereafter. Requires the Secretary to inform certain congressional committees 90 days before modifying such bid. Cites circumstances under which lands will be available for non-competitive leasing.

Increases the annual lease rental from 50 cents to $1.50 per acre for the first five years, and for a minimum of $2 per acre per year for each year thereafter. Sets forth a formula for the minimum royalty.

Requires the Secretary to give notice and make maps and narrative descriptions available to the public at least: (1) 45 days before offering lands for lease; and (2) at least 30 days before substantially modifying lease terms. Prescribes guidelines under which the Secretary (or the Secretary of Agriculture for national public domain forest lands) must regulate surface-disturbing activities conducted upon lease lands.

Cites circumstances under which the Secretary is authorized to disapprove certain lease assignments and subleases.

Authorizes the Secretary to disapprove specified lease assignments at his discretion. Amends lease cancellation conditions to provide that leases will not be cancelled due to the lessee's non-compliance with lease terms if: (1) the leasehold contains a well capable of oil or gas production in paying quantities; or (2) the lease is committed to an approved cooperative, unit plan, or communitization agreement which contains a well capable of unitized substances production in paying quantities.

Amends the Alaska National Interest Lands Conservation Act regarding oil and gas leases to bring it into conformance with this Act.

Prohibits the processing of noncompetitve lease applications or offers for specified public lands pending on the date of enactment of this Act until such lands are posted for competitive bidding in accordance with this Act. Reinstates noncompetitive applications for such lands if the national minimum acceptable bids are not forthcoming.

Sets forth guidelines for the promulgation of regulations regarding lease sales.

Imposes civil and criminal penalties upon persons who misrepresent the value of lands and leases under this Act. Empowers States to bring civil enforcement actions in Federal district courts.

Requires the Secretary to report annually to the Congress for five years after enactment of this Act certain information to facilitate congressional monitoring of this Act.

Directs the National Academy of Sciences and the Comptroller General to conduct a study regarding the manner in which oil and gas resources are considered in land use plans developed by the Secretary of the Interior and the Secretary of Agriculture.

Prohibits the issuance of oil or gas leases upon certain lands allocated or designated as wilderness areas.

States that Federal law regarding competitive leasing of oil and gas for onshore Federal lands may be cited as the "Mineral Leasing Act".

Subtitle C: Land and Water Conservation Fund and Tongass Timber Supply Fund - Amends the Land and Water Conservation Fund Act of 1965 to increase from $10 to $25 the charge for the annual admission permit (the Golden Eagle Passport) into any entrance fee area of the National Park System.

Authorizes the Secretary of the Interior to make available an annual admission permit for a reasonable fee for a specific unit or units of the National Park System.

Sets fee limits for single-visit permits.

Prohibits charging fees at any National Park unit located in an urbanized area.

Directs the Secretary to report to specified congressional committees a list of units and their proposed admission fees.

Prohibits admission fees for persons 16 years of age or less or for organized educational groups.

Prohibits charges at: (1) the U.S.S. Arizona Memorial, Hawaii; (2) Independence National Historical Park, Pennsylvania; (3) any National Park System unit within the District of Columbia; (4) the Robert E. Lee National Memorial; (5) San Juan National Historic Site; and (6) Canaveral National Seashore.

Requires a "Fee-Free Day" at each unit where a fee is charged.

Sets admission fee limitations for Yellowstone, Grand Teton, and Grand Canyon National Parks.

Authorizes the Secretary to charge an admission fee at Denali National Park and Preserve in Alaska.

Makes admission fees available to the collecting agency for resource protection, research, interpretation, and maintenance at outdoor recreation facilities managed by that agency.

Allocates ten percent of the funds collected by the National Park Service to Park units based upon need; 40 percent for operating expenses; and 50 percent based on user and admission fees.

Permits the use of such funds for resource protection, research, and interpretation, and in the case of funds from user fees, for maintenance.

Authorizes volunteers or others to sell permits and collect fees if adequately trained and bonded.

Permits the charge of a transportation fee in lieu of an entrance fee at parks with transportation systems. Provides for the distribution of such funds with the park itself retaining 50 percent outright.

Directs the Secretary to study the feasibility of adjusting entrance fees to encourage alternative transportation usage and visitation at off-peak times. Requires the study to include a pilot program at Yosemite National Park. Directs the Secretary to report to specified congressional committees within three years on such study.

Extends the Land and Water Conservation Fund through FY 2015.

Amends the Alaska National Interest Lands Conservation Act to repeal the ongoing appropriations for timber utilization in the Tongass National Forest, Alaska. Authorizes appropriations to maintain a specified level of timber supply.

Subtitle D: Reclamation - Authorizes the Secretary of the Interior to sell or otherwise dispose of loans made pursuant to the Distribution System Loans Act, the Small Reclamation Projects Act, and the Rehabilitation and Betterment Act in such amounts as to realize net profits to the Federal Government of at least $130,000,000 in FY 1988.

Amends the Reclamation Reform Act of 1982 to direct the Secretary to conduct an audit of compliance with the reclamation laws of the United States. Requires an annual report to specified congressional committees.

Requires the imposition of full cost pricing to irrigation water delivered to lands subject to a recordable contract executed prior to October 12, 1982.

Requires the Secretary to collect any underpayments (with interest) for irrigation water delivered pursuant to reclamation law.

Specifies the conditions under which lands placed in a revocable trust shall be attributable to the grantor.

Subtitle E: Panama Canal - Part 1: Panama Canal Reauthorization - Authorizes appropriations for FY 1988 for the necessary expenses of the Panama Canal Commission (Commission), limiting the amount of any funds appropriated which may be made available for the acquisition, construction, replacement, and improvement of facilities, structures, and equipment.

Amends the Panama Canal Act of 1979 to authorize the Panama Canal Commission to purchase insurance covering unpredictable events as well as the coverage for marine accidents authorized by current law.

Authorizes the Commission to contract for the lease of and improvements to real property in the United States for the use of the Commission as office space.

Provides for the compensation of members of the supervisory board of the Commission while on official Commission business.

Revises the limits on the amount which the Commission may pay: (1) with respect to claims for injury to, or loss of, property or personal injury or death arising from operation of the Canal; and (2) regarding injuries incurred in the locks of the Canal when the vessel was not under the control of a Panama Canal pilot.

Sets forth reporting requirements.

Part 2: Panama Canal Revolving Fund -Panama Canal Revolving Fund Act - Amends the Panama Canal Act of 1979 to terminate the present Panama Canal Commission Fund and Panama Canal Emergency Fund and establish in the Treasury a Panama Canal Revolving Fund (Fund). Makes amounts in such Fund available to carry out the authorized purposes, functions, and powers of the Panama Canal Commission (Commission). Provides that such Fund shall consist of the balance of the Panama Canal Commission Fund, the balance of unexpended appropriations to the Commission, the balance of the Panama Canal Emergency Fund, toll receipts and all other receipts of the Commission.

Prohibits funds from being obligated or expended by the Commission in any fiscal year unless the obligation or expenditure has been specifically authorized by law. Provides for an exception to the prohibition, allowing the Commission, in the event authorizing legislation for a fiscal year has not been enacted, to withdraw funds from the Fund for emergency expenses and to ensure the continuous, efficient, and safe operation of the Canal, including expenses for capital projects, but excluding administrative expenses.

Authorizes the Commission to borrow from the Treasury, for any of the purposes of the Commission, not more than $100,000,000, outstanding at any time.

Provides for the calculation and payment of interest on the investment of the United States in the Canal to the Treasury.

Adds working capital to the list of costs of operating and maintaining the Canal which: (1) must be paid from unexpended funds before making certain payments to the Republic of Panama; and (2) toll rates must be set to cover.

Subtitle F: Abandoned Mine Funds in Wyoming - Authorizes the State of Wyoming to expend a certain amount of abandoned mine reclamation funds for direct assistance to citizens evacuated from their homes in Campbell County due to hazards from methane and hydrogen sulfide gases.

Subtitle G: Nuclear Regulatory Commission User Fees - Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 to provide that for FY 1988 and 1989 the maximum amount of aggregate annual user charges that the Nuclear Regulatory Commission may assess shall be increased by an additional six percent of its incurred costs plus all other assessments made pursuant to a specified House joint resolution. Prohibits such percentage from being less than a total of 45 percent of such costs for such fiscal year.

Title VI: Civil Service and Postal Service Programs - Provides for deferred payments of the lump-sum credit payable to Federal employees or Members of Congress who elect an alternative form of annuity, if the commencement date of such annuity occurs after January 3, 1988, and before October 1, 1989.

Establishes a Postal Service Escrow Fund for the deposit of a specified amount by October 31, 1988. Terminates such Fund on October 1, 1989 and transfers such amounts into the Postal Service Fund. Requires the Postal Service to deposit a specified amount into the Civil Service Retirement and Disability Fund in FY 1988. Limits expenditures from the Postal Service Fund for the capital investment program for FY 1988 and 1989.

Requires the Postal Service to make specified contributions to the Employee Health Benefits Fund for FY 1988 and 1989, without: (1) increasing borrowing authority; (2) using budgetary resources other than those derived from its operating budget; or (3) increasing postal rates. Requires reports to specified congressional committees on meeting contribution guidelines and goals. Directs the General Accounting Office to audit compliance with such requirements.

Title VII: Veterans Programs - Amends Federal veterans' benefits provisions relating to default procedures on a Veterans Administration (VA) guaranteed home loan to authorize the Administrator of Veterans Affairs, before October 1, 1989, to sell with or without recourse (as determined by the Administrator to be in the best interest of the functioning of the VA home loan guaranty program) notes evidencing such guaranteed loans. Requires the Administrator, in comparing the cost-effectiveness of selling such notes either with or without recourse, to determine and consider: (1) the average amount by which the selling price for such notes with recourse would exceed the selling price for such notes sold without recourse; and (2) the total cost of selling such notes with recourse. Directs the Administrator, no later than 60 days after making any such note sale, to report to the Senate and House Veterans' Affairs committees describing such sales and any action taken by the Administrator with respect to such sales.

Extends the veterans' guaranteed home loan fee (the one percent fee generally imposed on veterans who obtain a loan guaranteed, insured, or made by the VA) through September 30, 1989.

Revises the percentage of purchases of property acquired by the Administrator as the result of defaults on veterans' housing loans that may be financed by VA loans in FY 1988 through 1990. States that such change achieves certain savings as required under the Balanced Budget and Emergency Deficit Control Reaffirmation Act of 1987 by changing program requirements.

Outlines certain rules for construction for identical changes made under this title and under provisions of the Veterans' Home Loan Program Improvements and Property Rehabilitation Act of 1987.

Title VIII: Budget Policy and Fiscal Procedures - Sets forth levels of budget authority and budget outlays for FY 1988 and 1989 for: (1) defense; and (2) domestic discretionary spending. Requires the House Committee on the Budget to report a budget resolution for FY 1989 containing such budget levels. Makes it out of order in the Senate, unless waived or suspended by a three-fifths' vote, to consider any concurrent resolution on the budget for FY 1989 that would fail to be consistent with such budget levels. Requires the allocations to be included in the joint explanatory statement accompanying the conference report on the FY 1989 budget resolution to be based on such budget levels.

Rescinds the sequestration orders issued by the President on October 20, 1987, and November 20, 1987, pursuant to the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) and restores sequestered funds.

Makes technical amendments to the Congressional Budget Act of 1974.

Commits the Congress to pass legislation in the FY 1989 budget process sufficient to achieve the specified budget summit agreement amount of asset sales in FY 1989.

Title IX: Income Security and Related Programs - Subtitle A: OASDI Provisions - Part 1: Coverage and Benefits - Amends the IRC and title II (Old Age, Survivors and Disability Insurance) (OASDI) of the Social Security Act to include inactive duty military training as covered employment.

Amends the OASDI program and the IRC to treat as covered wages all cash pay of agricultural employees whose employers spend $2,500 or more a year for agricultural labor.

Considers employer payments into an employee life insurance plan as covered wages if such payments are included in the employees' gross income under the IRC.

Includes as covered employment services performed by one spouse in the employ of the other spouse, except for domestic services performed in the employer spouse's home. Reduces to 18 the age after which services performed in a parent's employ may be treated as employment, but requires a child to be 21 before service outside the employing parent's trade or business or domestic service in the parent's home will be considered employment.

Amends the IRC to include employee tips within the wages on which social security employer taxes are based.

Amends the OASDI program to make the reductions in survivors' benefits that are made to offset government pensions applicable to Federal employees receiving pensions under the Federal Employees' Retirement System or the Civil Service Retirement System, unless their pensions are based on at least five years of service after 1987.

Authorizes the modification of an agreement between the Secretary and Iowa, providing OASDI coverage for certain State and local employees, to make police and firemen in Iowa eligible for OASDI coverage.

Extends, until June 1989, the continuation of disability benefits pending an individual's appeal of the termination of such benefits.

Preserves an individual's eligibility for disability benefits for at least 36 months following his or her engagement in trial work, unless such individual has engaged in substantial gainful activity in three of those months.

Part 2: Other Social Security Provisions - Rescinds the rule that fees in excess of $1,500 charged by attorneys for representing claimants who appeal Social Security Administration (SSA) decisions be approved by the regional office of the SSA rather than by the administrative law judge. (Fees in excess of $3,000 will have to be approved by the regional office.) Prohibits the Secretary or the SSA from modifying rules relating to attorneys' fees in connection with claims for OASDI benefits. Directs the Secretary and the Comptroller General to conduct simultaneous studies of the process by which attorneys' fees are authorized and paid and submit such studies to the Congress by July 1, 1988.

Treats the earnings of corporate directors as received when services are performed, regardless of when actually paid, for purposes of the tax on self-employment income and the OASDI earnings test.

Part 3: Railroad Retirement Program - Amends the Railroad Retirement Tax Act to increase the tier 2 railroad retirement percent to 4.9 percent; and (2) for employers from 14.75 percent to 16.1 percent.

Establishes the Commission on Railroad Retirement Reform to conduct a comprehensive study of the issues relating to the long-term financing, structure, and objectives of the railroad retirement system. Requires that the resulting report, including detailed findings, conclusions, and recommendations, be submitted to the President and to the Congress no later than October 1, 1989. Terminates the Commission 60 days after submission of its report.

Amends the Railroad Retirement Solvency Act of 1983 with respect to certain transfers to the Railroad Retirement Account to: (1) extend the applicability of the provision to benefits received through FY 1989 (currently FY 1988); and (2) repeal a limitation on the aggregate transferable amount in connection with such transfers.

Subtitle B: Provisions Relating to Public Assistance and Unemployment Compensation - Part 1: AFDC and SSI Amendments - Amends the Deficit Reduction Act of 1984 to permanently disregard in-kind assistance provided by nonprofit organizations to Supplemental Security Income (SSI) program (title XVI of the Social Security Act) and Aid to Families with Dependent Children (AFDC) program (part A of title IV of the Social Security Act) beneficiaries in determining the need or eligibility of such recipients.

Amends the AFDC program to authorize States to establish and operate an AFDC fraud control program under which an individual who fraudulently establishes or maintains his or her family's AFDC eligibility shall have his or her needs ignored in determining the family's need for AFDC assistance. Sets the Federal share of the costs of such fraud control program at 75 percent.

Amends the SSI program to exclude real property which, for specified reasons, cannot be sold from SSI resource eligibility determinations.

Directs the Secretary, where necessary to avoid undue hardship, to suspend the penalties applied when individuals become SSI eligible by disposing of their resources at less than market value.

Provides that SSI benefits shall not be reduced to the extent that amounts set aside for burial and related expenses are used for other purposes if the amount used for other purposes would not cause the individual to exceed SSI resource limits.

Excludes AFDC and certain other assistance payments from SSI income eligibility determinations.

Authorizes States to treat a husband and wife living in the same medical facility, whether or not they share a room, as though they were an SSI-eligible individual and eligible spouse rather than two eligible individuals.

Extends, until July 1, 1988, for disabled widows or widowers who became ineligible for SSI benefits by reason of the increase in OASDI benefits caused by the Social Security Amendments of 1983 the deadline to apply for Medicaid coverage.

Authorizes the Secretary to make an emergency cash advance to presumptively eligible individuals who are initially applying for SSI benefits up to the amount which would be payable for the first month to an eligible individual with no other income.

Extends Federal reimbursement of State interim SSI assistance provided for the period during which an individual's benefits were erroneously terminated or suspended.

Entitles individuals who are applying for a receiving SSI benefits on the basis of blindness to elect to receive supplementary notice by telephone, inital notice by certified mail, or notice by some alternative procedure of any determination made or other action taken with respect to such individual's SSI rights. Directs the Secretary to study the desirability and feasibility of extending such notices to other individuals who may lack the ability to read.

Continues the provision of SSI benefits to individuals whose blindness has ceased if they are participating in an approved vocational rehabilitation program under the same conditions as apply to the disabled.

Prohibits individuals who are in a public emergency shelter for the homeless for more than six months in any nine-month period from being eligible for SSI payments. (Currently, SSI eligibility terminates when an individual has been in such a shelter for more than three months in a 12-month period.)

Excludes retroactive SSI and OASDI payments received during the two-year period beginning on October 1, 1987, from SSI resource eligibility determinations for nine months. (Currently, such payments are excluded for six months.)

Continues the provision of full SSI benefits to individuals whose institutionalization is likely not to exceed three months during a continuous period of institutionalization and who need to continue to maintain and provide for the expenses of the home or living arrangement to which he or she may return after institutionalization.

Treats individuals who are ineligible for SSI benefits by reason of their receipt of widow's or widower's insurance benefits under the OASDI program as SSI recipients for purposes of the Medicaid program.

Authorizes the Secretary to make grants to States for projects designed to demonstrate and test the feasibility of special procedures and services to ensure that individuals receive SSI and other Social Security Act benefits to which they are entitled and receive assistance in using such benefits to obtain permanent housing, food, and health care.

Prohibits Secretary from implementing, prior to October 1, 1988, a specified proposed regulation regarding assistance for homeless AFDC families.

Increases SSI benefits payable to residents of medical facilities. Requires States making supplementary payments to residents of medical facilities who are receiving SSI benefits to increase and then maintain them at the increased level.

Excludes death benefits from an individual's income for SSI eligibility purposes to the extent such benefits do not exceed amounts such individual expended on the decreased person's last illness and burial.

Authorizes the Secretary to approve, as alternatives to the AFDC program, five-year demonstration projects testing: (1) Washington State's Family Independence Program; and (2) New York State's Child Support Supplement Program.

Part 2: Social Services, Child Welfare Services, and Other Provisions Relating to Children - Amends the Adoption Assistance and Child Welfare Act of 1980 to extend indefinitely the provision permitting Federal financial participation in foster care for certain children voluntarily placed in such care.

Amends part E (Foster Care and Adoption Assistance) of title IV of the Social Security Act to extend, through 1989: (1) the conditional ceiling on Federal financial participation in foster care; and (2) the provision which permits a State to use, under the Child Welfare Services program, funds made available to it under the conditional ceiling that are not needed under part E.

Provides that where a child for whom foster care payments are being made resides in the same foster home or child-care institution as his or her son or daughter the payments made for such child shall include the cost of certain items provided to or on behalf of the child's son or daughter.

Amends title XX (Block Grants to States for Social Services) of the Social Security Act to increase funding for such grants in FY 1988. Amends part A (General Provisions) of title XI of such Act to include American Samoa in the Social Services Block Grant program and the Child Welfare Services program under part B (Child Welfare Services) of title IV of such Act.

Establishes a National Commission on Children which is to serve as a forum on behalf of children and submit an interim report to the Congress and the President by September 30, 1988, and a final report by March 31, 1989, regarding questions relating to: (1) the health of children; (2) social and support services for children and their parents; (3) education; (4) the tax policy regarding children; and (5) poverty among children.

Amends part B (Child Welfare Services) of title IV of the Social Security Act to authorize appropriations for FY 1988 through 1990 so that the Secretary may make grants to public or private nonprofit entities for the development of alternative care arrangements for infants who do not require hospitalization but would otherwise remain in inappropriate hospital settings.

Directs the Secretary to conduct a survey regarding: (1) the number of infants and children with acquired immune deficiency syndrome (AIDS) who have been placed in foster care; (2) the problems encountered by social service agencies in placing such infants and children in foster care; and (3) the potential increase in the number of infants and children with AIDS who will require foster care. Requires the Secretary to report to the Congress, within one year of this Act's enactment, regarding such survey and means of improving the care provided to such infants and children.

Part 3: Child Support Enforcement Amendments - Amends part D (Child Support and Establishment of Paternity) of title IV of the Social Security Act to continue to provide child support enforcement services to families which cease to receive AFDC payments. Requires States to provide child support enforcement services to families covered under the Medicaid program. Eliminates the Child Support Revolving Fund in the Treasury.

Part 4: Unemployment Compensation - Changes the effective date for certain extended unemployment benefits program disqualification requirements for purposes of the determination of the amount of the Federal payment to a State under the Federal-State Extended Unemployment Compensation Act of 1970.

Directs the Secretary of Labor to enter into agreements with three States for a demonstration program to provide self-employment allowances in lieu of regular or extended unemployment compensation to a certain number of eligible individuals. Requires States to provide specialized services to such individuals. Makes State and Federal requirements relating to availability for work, active search for work, or refusal to accept suitable work inapplicable to such individuals. Requires State evaluation of such program. Directs the Secretary to report to the Congress on such program two years and four years after the enactment of this Act.

Amends the Federal Unemployment Tax Act (FuTA) to extend the 6.2 percent rate of the gross employer tax through 1988, 1989, and 1990 (thus extending the 0.2 percent surtax for three years). Lowers such rate to 6.0 percent for 1991 and thereafter.

Amends the Social Security Act to direct the Secretary of the Treasury to transfer the amount of additional revenue from such FuTA surtax from the employment security administration account as follows: (1) 50 percent to the Federal unemployment account; and (2) 50 percent to the extended unemployment compensation account. Increases the limitation on the amounts in the two latter accounts from 0.125 to 0.375 of total covered wages.

Sets forth a rate of interest on advances to the Federal unemployment account and the extended unemployment compensation account.

Credits to the Federal unemployment account interest paid by States on advances.

Subtitle C: Manufacturers Excise Tax on Certain Vaccines - Amends Chapter 32 of the Internal Revenue Code of 1986 (relating to manufacturers excise taxes) to impose a tax on the first sale of any taxable vaccine sold by the manufacturer, producer, or importer of the vaccine. Sets forth a table listing the amount of tax imposed per does of DPT vaccine (relating to pertussis), DT (relating to diphtheria or tetanus), MMR vaccine (relating to measles, mumps, or rubella), and polio vaccine. Prohibits imposition of the tax if the Secretary of the Treasury estimates that the amounts collected would exceed the projected Vaccine Injury Compensation Trust Fund liability. Provides for credit or refund of the tax whenever any vaccine on which tax was imposed is returned to the person who paid the tax or destroyed.

Establishes in the Treasury the Vaccine Injury Compensation Trust Fund. Appropriates to the Fund amounts equivalent to the net revenues received from the tax imposed.

Subtitle D: Pension Provisions - Part I: Full-Funding Limitation - Amends the IRC and the Employee Retirement Income Security Act of 1974 (ERISA) to revise the definition of "full funding limitation" in connection with an employer's deductible contributions to a qualified defined benefit plan.

Directs the Secretary of the Treasury, by August 15, 1988, to: (1) prescribe regulations to implement these new full-funding limitation provisions; and (2) study and report to specified congressional committees on the effect of the change on benefit security under defined benefit pension plans.

Part II: Pension Funding and Termination Requirements - Pension Protection Act - Subpart A: Modifications of Minimum Funding Standard - Amends the IRC and ERISA to increase the amount charged to the funding standard account in the case of single employer defined benefit plans having more than 100 participants and an unfunded current liability for any plan year. Sets forth the formula for determining the amount of this increase. Limits the increase to the amount necessary to increase the funded current liability percentage to 100 percent.

States that, with respect to plan years 1988 and thereafter, certain regulations that permit, for pension plan funding purposes, asset valuations based on a range of average value shall have no force and effect, except with respect to multiemployer plans.

Authorizes the Secretary of the Treasury to issue regulations with respect to the interest rate used to value a dedicated bond portfolio.

Sets out special rules for increases in the funding standard account with respect to steel companies.

Amends the IRC and ERISA to: (1) revise provisions governing the period during which employer contributions to pension plans may be made after the close of a plan year; (2) require quarterly estimated payments; and (3) set an interest rate to be applied in the event of contribution underpayments.

Amends the IRC to increase from five percent to ten percent (five percent for multiemployer plans) the rate of the initial tax on the amount of the accumulated funding deficiency when an employer fails to meet minimum pension plan funding standards.

Amends ERISA to require an employer who fails to meet minimum funding standards to notify plan participants and beneficiaries under the plan of such failure.

Amends the IRC and ERISA to impose a lien when: (1) any person fails to meet minimum funding standards; and (2) the cumulative unpaid balance due exceeds $1,000,000. Applies the lien to all property and property rights of the delinquent person and of any other person belonging to the same controlled group as that person. Requires the offending person to notify the corporation of such failure to pay required amounts.

Amends the IRC to provide for joint and several liability with respect to liability for taxes on the failure to meet minimum funding standards or to make minimum funding contributions in cases when the employer is a member of a controlled group.

Amends the IRC and ERISA with respect to waivers in connection with payments required to meet minimum funding standards, including provisions relating to the time for requesting waivers, the frequency of waivers, and the interest rate applicable to repayments of waiver contributions. Decreases from $2,000,000 to $1,000,000 the threshold amount with respect to the accumulated funding deficiency for which the Internal Revenue Service may require security.

Makes other funding changes in both the IRC and ERISA, including revisions of amortization periods and the interest rate applicable to the funding standard account.

States that the maximum amount of the income tax deduction for employer contributions to defined benefit plans having more than 100 participants shall not be less than the unfunded current liability.

Subpart B: Plan Terminations - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to set limitations or reversions of excess assets to employers upon plan termination. Restricts such reversions pursuant to recently amended plans by treating any plan provision for the distribution of plan assets to the employer and any amendment increasing the amount which may be distributed to the employer as not effective before the end of the fifth calendar year following the date of its adoption. Exempts from such restriction any plan which has been in effect for fewer than five years and which has provided for such a distribution since its effective date. Makes such restriction continue to apply separately with respect to the amount of assets transferred in transactions such as plan mergers. Sets forth a transitional rule.

Provides for distribution of assets attributable to employee contributions, if such assets are in excess of the plan's benefit liabilities (i.e. its termination liability), among participants, beneficiaries, alternate payees, and persons who received a total distribution of plan benefits during the three-year period before plan termination. Sets forth a fomula for determining the portion of such remaining assets which are attributable to employee contributions.

Repeals provisions for the section 4049 trust, the termination trust mechanism for payment of plan benefits above guaranteed levels. Eliminates employer liability to such section 4049 trust. Increases employer liability to the Pension Benefit Guaranty Corporation (PBGC) to equal the total amount of the unfunded benefit liabilities as of the termination date to all participants and beneficiaries under the plan, together with specified interest. Limits the PBGC's lien to no more than 30 percent of the collective net worth of all liable entities. Sets forth a formula for determining liability in the case of multiple controlled groups.

Directs the PBGC, in addition to other specified benefits paid with respect to a terminated plan, to pay to participants and beneficiaries a recovery percentage of the outstanding amount of benefit liabilities. Sets forth formulas for determining such payments.

Provides for a reduction of liability payments by the amount of reasonable administrative expenses incurred under section 4049 trust provisions under prior terminations.

Revises provisions relating to standards for termination. Increases the required plan asset level for a standard termination to the full level of the plan's benefit liabilities.

Revises provisions relating to criteria for distress terminations. Requires that all members (not only substantial members) of a controlled group satisfy the distress termination criteria. Requires, for a distress termination in the case of a reorganization, that the bankruptcy court (or other appropriate court) determine that unless the plan is terminated the entity will be unable to pay all its debts pursuant to a reorganization plan and to continue in business outside the reorganization process. Declares that the determination of whether distress criteria have been met for a bankruptcy proceeding must be made as of the proposed termination date. Treats a reorganization that has been converted to a liquidation as a liquidation for distress termination determinations. Requires that the PBGC be notified in advance that the entity intends to request approval of the distress termination by the bankruptcy or other appropriate court.

Authorizes the PBGC to make arrangements with contributing sponsors and members of their controlled groups who may become (as well as those who are) liable for specified termination liability payments.

Provides that certain information related to the certification of an enrolled actuary is not required in the case of a standard or distress termination of certain plan funded exclusively by individual insurance contracts.

Authorizes the PBGC to pool assets of terminated plans for appropriate purposes.

Requires a plan administrator, upon PBGC request, to furnish specified plan information in the case of an involuntary termination.

Authorizes the PBGC to assess civil penalties for failure to provide any notice or other material information required under ERISA plan termination insurance provisions.

Subpart C: Increases in Premium Rates - Increases PBGC premium rates for employers maintaining single-employer defined benefit plans under ERISA plan termination insurance. Increases the flat-rate per-participant premium to $16. Charges an additional per-participant premium to the extent the plan is underfunded. Sets such additional per-participant premium at $6 per $1,000 of unfunded vested benefits, up to a maximum additional premium of $34 per-participant. Sets forth a formula for the interest rate used in valuing vested benefits for such purposes. Reduces (during the first five plan years the additional premium is in effect) $34 per-participant maximum additional premium by $3 for each plan year for which an employer made the maximum deductible contributions during one or more of the five plan years preceding the first plan year to which such additional premium applies.

Makes the contributing sponsor (as well as the plan administrator) of a single-employer plan liable for premium payments. Makes each member of a controlled group liable for any premiums required to be paid by such contributing sponsor.

Establishes a separate revolving fund to which such additional premiums are to be credited. Allows transfers of such amounts to other funds, but prohibits their being used to pay PBGC administrative expenses or benefits under any plan terminated before October 1, 1988, unless no other PBGC assets are available.

Subpart D: Miscellaneous Provisions - Amends the Internal Revenue Code (IRC) and ERISA to require security upon the adoption of any plan amendment resulting in significant underfunding. Requires the contributing sponsor (and the members of the sponsor's controlled group) of a defined benefit plan (other than a multiemployer plan) to provide such security in specified forms. Sets forth a formula for determining the amount of such security. Provides for release of such security when specified conditions are met.

Requires the employer to include in the annual report to plan participants the relevant percentage if the value of plan assets is less than 60 percent of current liability.

Repeals an ERISA provision under which the statute of limitations begins to run on the filing date of a report from which the plaintiff could reasonably be expected to have obtained knowledge of a breach of fiduciary responsibility.

Authorizes the Secretary of Labor to assess civil penalties for a plan administrator's failure or refusal to file a required annual report in complete form.

Makes inapplicable in interpreting the IRC any ERISA provisions for protection of employee benefit rights and for pension termination guaranty insurance, except to the extent specifically provided in the or as determined by the Secretary of the Treasury.

Provides that the determination of the Secretary of the Treasury in a determination letter by the Internal Revenue Service shall not be prima facie evidence on issues relating to ERISA provisions for Department of Labor enforcement of fiduciary standards.

Permits a return of contributions to an employer under ERISA if the contribution is conditioned on initial qualification of the plan under specified IRC provisions: (1) if the plan does not qualify initially; and (2) if the application for determination relating to initial qualification is filed by the due date of the employer's return for the taxable year in which the plan was adopted.

Limits the ERISA penalty for prohibited transactions to: (1) five percent of the amount involved for each such transaction for each year or part thereof during which the prohibited transaction continues; or (2) 100 percent of the amount involved, if the transaction is not corrected within 90 days after notice from the Secretary Labor.

Sets forth additonal ERISA limitations on investment by an individual account plan forming part of a floor offset arrangement and on investment by an individual account plan in employer stock. Restricts treatment of stock as a qualifying employer security. Provides, in the case of a plan other than an eligible individual account plan, that stock shall be considered a qualifying employer security only if: (1) not more than 25 percent of the aggregate amount of stock of the same class issued and outstanding at the time of acquisition is held by the plan; and (2) at least 50 percent of the aggregate amount of such stock is held by persons independent of the issuer.

Revises the interest rate on accumulated contributions under ERISA and IRC requirements for crediting interest on mandatory employee contributions to a defined benefit pension plan. Replaces the five percent interest rate with one equal to 120 percent of the applicable Federal mid-term rate.

Subtitle E: Miscellaneous Provisions - Requires the Secretary, within 30 days after the expiration of any debt issuance suspension period, to issue to each Federal fund certain obligations necessary to ensure that the holdings of such fund will replicate to the maximum extent practicable the obligations that would have been held by such fund if: (1) failure to invest amounts in such fund due to the public debt limit had not occurred; and (2) issuance of such obligations had occurred immediately on the expiration of such suspension period. Requires the Secretary to credit to: (1) each fund the income and interest not earned due to such failure to invest; and (2) each holder of State and local Government Series obligations the interest lost due to such failure to invest. Requires such amounts credited to be treated as interest on such obligations.

Amends the Deficit Reduction Act of 1984 to extend through July 1, 1988, provisions relating to the collection of non-tax debts owed to Federal agencies. Requires the Comptroller General to conduct a study on the effectiveness of such provisions.

Increases the amount of long-term bonds that may be issued by the Secretary of the Treasury.

Amends the Deficit Reduction Act of 1984 to extend through June 30, 1988, provisions under which overpayments of Federal taxes may be used to offset non-tax debts owed to Federal agencies. (Currently, such offsets are permitted with respect to refunds payable before 1988.)

Expresses the intent of the Congress that, to the extent practivable, the amendments made by the Deficit Reduction Act of 1984 with respect to the collection of non-tax debts owed to Federal agencies shall extend to all Federal agencies. Directs the Secretary of the Treasury to issue regulations to carry out the purposes of this paragraph.

Directs the Comptroller General to study the operation and effectiveness of these provisions and to report findings to specified congressional committees no later than April 1, 1989.

Increases from $250,000,000,000 to $270,000,000,000 the amount of long-term U.S. bonds which may be issued under the exception to the 4 1/4 percent limitation on the interest rates paid on such bonds.

Subtitle F: Customs User Fees; Trade and Customs Agency Authorizations - Amends the Consolidated Budget Reconciliation Act of 1985 to make articles returned to the United States after having been exported and articles assembled abroad in whole or in part of fabricated components which are products of the United States subject to the requirement that the Secretary of the Treasury collect a specified fee for the processing of any merchandise entered or withdrawn from warehouse for consumption in the United States.

Requires that the fee charged with respect to the processing of merchandise: (1) for articles returned to the United States after having been exported, be applied to the value of the foreign repairs or alterations to the merchandise; and (2) for merchandise assembled abroad, be applied to the full value of such merchandise, less the cost of value of U.S. products.

Allows the Secretary, for articles returned to the United States after having been exported or for articles of fabricated components assembled abroad, to collect the fee charged on the processing of the merchandise on the basis of aggregate data derived from financial and manufacturing reports used by the importer in the normal course of business.

Requires that customs services, when requested, be adequately provided for: (1) the clearance of any commercial vessel, vehicle, or aircraft arriving, departing, or transiting the United States; (2) the preclearance at any customs facility outside the United States of any commercial vessel, vehicle or aircraft; and (3) the inspection or release of commercial cargo being entered into, or withdrawn from the customs territory of the United States.

Requires that customs services be treated as adequately provided if the services needed to meet the needs of parties subject to customs inspection are provided in a timely manner, taking into account: (1) weather, mechanical, and other delays; (2) prompt and efficient passenger and baggage clearance; (3) the perishability of cargo; (4) late night and early morning arrivals; (5) the availability of customs personnel; and (6) the need for specific enforcement checks. Prohibits the collection of customs fees in addition to those statutorily prescribed for: (1) any preclearance or other customs activity, expense, or service performed outside the United States in connection with the departure of a vessel, vehicle, or aircraft for the United States; or (2) the activation or operation of any foreign trade zone or the designation or operation of any bonded warehouse.

Makes fees used for the direct reimbursement of specified appropriations an exception to the requirement that fees collected under the schedule of fees be deposited in the Customs User Fee Account in the general fund of the Treasury.

Requires that all funds in the Customs User Fee Account be available to pay the U.S. Customs Service's costs in conducting commercial operations. Prohibits the Secretary from reducing personnel staffing levels for providing commercial clearance and preclearance services if there is a surplus of funds in the Customs User Fee Account.

Requires the Secretary to directly reimburse, from fees collected for customs services, each appropriation for amounts paid for the costs incurred by the Secretary in providing inspectional overtime services and all preclearance service, beginning with each fiscal year occurring after September 30, 1987.

Requires the Secretary to prescribe regulations governing the work shifts of customs personnel at airports and providing that: (1) the work shifts will be adjusted to meet cyclical and seasonal demands and to minimize the use of overtime; (2) the work shifts will not be arbitrarily reduced or compressed; and (3) consultation with the Advisory Committee on Commercial Operations of the U.S. Customs Service will be carried out before making adjustments in work shifts.

Extends the customs user fees program through 1990.

Amends the Tax Reform Act of 1986 to extend the date for claiming certain refunds for fees for customs services until 90 days after the date of enactment of the Omnibus Budget Reconciliation Act of 1987 (currently, 90 days after the date of enactment of the Tax Reform Act of 1986).

Requires the Comptroller General to conduct a comprehensive analysis of the centralized cargo examination station (CES) concept and to submit such analysis to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate not later than March 30, 1988.

Directs the Customs Service to: (1) not establish any new CES at any ocean port, airport, or land border location, without providing advance notice of not less than 90 days to such committees; and (2) suspend, on the date of enactment of this Act, operations at each CES station until 90 days after a date on which the comprehensive analysis of the CES program by the Comptroller General is submitted to the committees and on which the Customs Service provides to the committees written notice of its intentions to resume operations at that station.

Requires the Secretary, during the period of suspension of operations at any CES station, to maintain customs operations and staffing at a level not less than that which was in effect immediately before the suspension took effect.

Amends the Tariff Act of 1930 to authorize appropriations for the International Trade Commission for FY 1988.

Amends the Customs Procedural Reform and Simplification Act of 1978 to authorize appropriations for the salaries and expenses of the Customs Service for noncommercial operations for FY 1988. Authorizes appropriations from the Customs User Fee Account for the salaries and expenses of the Customs Service for commercial operations for FY 1988.

Authorizes appropriations for the Customs Service's air interdiction program for FY 1988.

Requires the Commissioner of Customs to notify the Senate Committee on Finance and the House Committee on Ways and Means of any action which would: (1) result in a significant reduction in force of employees (other than by attrition) or in hours of operation of any U.S. Customs Service office or port of entry; (2) eliminate or relocate an office of the Service; (3) eliminate a port of entry; or (4) reduce the number of employees assigned to an office or port of entry of the Service.

Directs the Secretary to establish the Advisory Committee on Commercial Operations of the U.S. Customs Service which shall: (1) provide advice to the Secretary on matters relating to the commercial operations of the Service; and (2) submit an annual report to the Senate Committee on Finance and the House Committee on Ways and Means concerning Advisory Committee operations and recommendations regarding Service commercial operations.

Amends the Trade Act of 1974 to authorize appropriations for the Office of the United States Trade Representative for FY 1988, out of which only a specified amount may be used for entertainment and representation expenses.

Title X: Revenue Provisions - Revenue Act of 1987 - Subtitle A: Individual Income Tax Provisions - Amends the Internal Revenue Code (IRC) to exclude expenses of overnight camps from calculations of the dependent care income tax credit.

Revises the definition of "qualified residence interest" for purposes of the income tax deduction for personal interest to distinguish between acquisition indebtedness and home equity indebtedness. Limits to $1,000,000 and $100,000 respectively the amount of indebtedness on which interest is deductible.

Provides that Federal judges be treated as: (1) active participants for purposes of the limitation on the deduction of contributions to individual retirement plans; and (2) employees for purposes of the Internal Revenue Code generally.

Amends the IRC to delay until 1988 (currently 1987) application of the two-percent floor to indirect income tax deductions through pass-through entities with respect to any regulated investment company (RIC) whose shares are: (1) continuously offered pursuant to a public offering; (2) regularly traded on an established securities market; or (3) held by or for at least 500 persons at all times during the taxable year.

Increases from 90 percent to 98 percent the amount of a RIC's capital gain net income included as part of the required distribution for purposes of the excise tax on RIC undistributed income.

Subtitle B: Business Provisions - Part I: Accounting Provisions - Amends IRC accounting provisions to repeal the deduction for additions to an employer reserve for accrual of vacation pay.

Provides that for purposes of the employer deduction, vacation pay treated as deferred compensation shall be deductible for the year in which the payment is made.

Amends the IRC to repeal provisions under which a taxpayer's allocable installment indebtedness is allocated on a pro rata basis to certain installment obligations arising from dispositions of property by dealers, except with regard to certain farm property, timeshares, and residential lots. Repeals the proportionate disallowance rule in connection with nondealer installment obligations arising out of dispositions of certain real property used in the taxpayer's trade or held for rental income. Requires the payment of interest on tax deferrals on nondealer installment obligations that exceed $5,000,000. Treats the net proceeds of indebtedness secured by an installment obligation as payment of such obligation.

Revises accounting procedures used in connection with long-term contracts to: (1) decrease from 60 percent to 30 percent the percentage of items taken into account under the taxpayer's normal method of accounting; and (2) increase from 40 percent to 70 percent the percentage of items taken into account under the percentage of completion method.

Provides that for purposes of inventory cost capitalization and special accounting rules for long-term contracts, the allocable costs with respect to any property shall include contributions paid to or under a pension or annuity plan, regardless of whether the contributions represent past service costs.

Amends the IRC to require family corporations engaged in farming and having gross receipts exceeding $25,000,000 to use the accrual method of accounting for income tax purposes.

Permits a partnership, S corporation, or personal service corporation, unless it is part of a tiered structure, to elect to have a taxable year other than the required one, but generally only if the deferral period of the taxable year elected is three months or less. (Current law requires partnerships, S corporations, and personal service corporations, in most cases, to conform their taxable years to the calendar years used by their owners.)

Subjects the principals of a partnership or S corporation electing to change taxable years to additional estimated tax requirements to offset any tax deferral resulting from such election. Imposes deduction limitations on a personal service corporation that changes taxable years.

Provides that an election with respect to taxable year shall be made by the partnership, S corporation, or personal service corporation.

Sets forth the formula for determining the additional tax required when a partnership or S corporation has an aggregate deferred tax that exceeds $500 and elects not to have a required taxable year. Describes payment procedures.

Requires the inclusion of specified information on returns filed by partnerships and S corporations that elect to use a non-required taxable year.

Limits the tax deduction permitted to a personal service corporation for amounts paid or incurred with respect to employee-owners when such a corporation: (1) elects to have a taxable year other than the required one; and (2) fails to meet certain minimum distribution requirements regarding non-dividend amounts paid to owners.

Part II: Partnership Provisions - Provides that for purposes of the Internal Revenue Code a publicly traded partnership shall be treated as a corporation. Excepts from such treatment certain partnerships with passive-type income, unless the partnership would qualify as a regulated investment company and is not primarily active in commodity buying and selling activity. Provides for the treatment of publicly traded partnerships with respect to: (1) accounting rules applied to limitations of passive activity losses and credits; and (2) unrelated business taxable income of tax-exempt organizations. Revises criteria under which members of a partnership qualify for an exception from treatment as unrelated business income of any income from debt-financed real property.

Directs the Secretary of the Treasury to study and report to specified congressional committees by January 1, 1989, (with an interim report due May 1, 1988) on: (1) the issue of treating publicly traded limited partnerships and other corporation-like partnerships as corporations for income tax purposes, including the issues of disincorporation and opportunities for avoidance of the corporate tax; and (2) administrative and compliance issues related to the tax treatment of publicly traded partnerships and other large partnerships.

Part III: Corporate Provisions - Reduces from 80 percent to 70 percent the corporate tax deduction with respect to: (1) dividends received from a domestic corporation; and (2) dividends received on certain preferred stock. Retains the 80 percent deduction when 20 percent of more of the stock of the corporation (both vote and value) is owned by the taxpayer.

Amends IRC provisions relating to the computation and payment of tax by members of an affiliated group filing a consolidated tax return.

Disregards consolidation return regulations when determining whether an entity is an 80-percent distributee for purposes of nonrecognition of gain or loss in connection with property distributed to a parent corporation in a complete liquidation of a subsidiary.

Sets a fixed 34 percent tax rate with respect to the taxable income of personal service corporations. (Such corporations are currently subject to graduated corporate rates.)

Amends IRC provisions relating to limitations on net operating loss carryforwards and certain built-in losses following corporate ownership changes. Adds provisions limiting the use of preacquisition losses to offset built-in gains. Directs the Secretary of the Treasury to prescribe regulations to carry out the purposes of this latter change, including regulations to ensure that the new limitations may not be circumvented in certain ways.

Provides for the recapture of benefits resulting from the use of the LIFO (last-in, first-out) method of inventory accounting in the case of certain former C corporations electing to be S corporations.

Amends the IRC to impose a 50 percent excise tax on gain realized by greenmail recipients. Defines "greenmail" as any consideration transferred by a corporation to acquire (directly or indirectly) its stock from any shareholder if: (1) the shareholder held such stock for less than two years; (2) at some time during the two-year period the shareholder, a person acting in concert with the shareholder, or a person related to either made or threatened to make a public tender offer for the corporation's stock; and (3) the acquisition is pursuant to an offer that was not made on the same terms to all shareholders. Imposes the tax regardless of whether gain is actually realized. Disallows an income tax deduction for payment of this tax.

Part IV: Foreign Tax Provisions - Denies the foreign tax credit for taxes paid or accrued to South Africa until the Secretary of State certifies that South Africa meets specified criteria of the Comprehensive Anti-Apartheid Act of 1986.

Part V: Insurance Provisions - Amends IRC provisions relating to: (1) the interest rate used by life insurance companies in computing reserves for purposes of determining income; (2) rules governing the required surplus of foreign corporations carrying on insurance business; and (3) the treatment of mutual life insurance company policyholder dividends for purposes of book preference.

Directs the Secretary of the Treasury to: (1) study the proper Federal income tax treament of income earned by members of insurance or reinsurance syndicates and report findings to specified congressional committees by April 1, 1988; and (2) renegotiate by January 1, 1990, a specified closing agreement with underwriters participating in certain insurance or reinsurance syndicates.

Subtitle C: Estimated Tax Provisions - Amends IRC provisions dealing with estimated income tax payments by corporations.

Establishes the amount of the penalty for underpayment of estimated tax at the amount of the underpayment for the period of underpayment, plus interest on such amount. Revises the schedule for the payment of estimated tax installments. Specifies that the amount of the required annual estimated tax payment shall be the lesser of: (1) 90 percent of the current tax shown on the taxpayer's return (corporations having a taxable income of at least $1,000,000 for any taxable year during a specified period must use this option); or (2) 100 percent of the preceding year's tax liability. Permits lower estimated tax payments if the taxpayer can show that the installment payments or adjusted seasonal installments made over the year were adequate for each quarter based on annualized income and adjusted seasonal installment concepts described in this bill.

Exempts from an estimated tax penalty any taxpayer whose tax liability is less than $500.

Requires an addition to income tax when an adjustment of overpayment of estimated income tax by a corporation, made before the 15th day of the third month following the close of the taxable year, is found to be excessive.

Repeals provisions of the IRC dealing with installment payments of estimated income tax by corporations.

Amends the IRC to allow employers to elect to have revised withholding certificates put into effect more promptly than is required under current law.

Delays for one year, from 1987 until 1988, implementation of the increase from 80 percent to 90 percent in the current year liability test for estimated tax payments by individuals.

Prohibits an addition to any tax imposed on underpayments of estimated tax installments by corporations due on or before June 15, 1987, under certain circumstances (thus permitting corporations to use their 1986 tax in determining certain estimated tax installment amounts).

Subtitle D: Estate and Gift Tax Provisions - Part I: General Provisions - Extends through 1992 the 1987 estate and gift tax rates, the highest of which is 55 percent (applied to transfers over $3,000,000). Phases out the benefits of graduated rates and the unified credit with respect to transfers of between $10,000,000 and $21,040,000 ($18,040,000 as of 1993).

Limits valuation freezes, with an exception for certain family transfers, by providing that if a person holding ten percent or more of the interest in an enterprise transfers a disproportionately large share of the potential appreciation in the enterprise while retaining a disproportionately large share in the income of, or rights in, that enterprise, the retention of the retained interest shall be included in the transferor's gross estate.

Part II: Estate Tax Provisions Relating to Employee Stock Ownership Plans - Amends the Internal Revenue Code to revise provisions relating to the estate tax deduction for proceeds received from a sale of employer securities to an employee stock ownership plan (ESOP) or worker-owned cooperative. Makes such a deduction available only if: (1) the decedent directly owned the securities immediately before death; and (2) after the sale, the securities are either allocated to participants or held for future allocation in connection with certain exempt loans or transfers of assets.

Prohibits, except in a bona fide business transaction, the treatment of employer securities as allocated or held for future allocation insofar as they are so categorized in substitution of other employer securities so designated.

Applies the deduction to any sales of qualified employer securities (current law applies only to sales made by the executor of the estate).

Prohibits the amount of the deduction from exceeding: (1) the amount that would lead to a reduction in estate tax liability (before credits) equal of $750,000; or (2) 50 percent of the taxable estate.

Disallows proceeds from being taken into account when: (1) they exceed the net sale amount of dispositions of employer securities by the plan during the year preceding the sale in question; (2) they are attributable to transferred assets (except for assets held by the ESOP on February 26, 1987); (3) the sale takes place after the estate tax return filing deadline; or (4) the decedent received the securities under certain specified conditions.

Applies the deduction to employer securities that are: (1) issued by a domestic corporation having no stock outstanding that is readily tradable on an established securities market; (2) includable in the gross estate of the decedent; and (3) would have been includable if the decedent had died within a specified time period.

Revises the requirements governing the contents of the written statement to be submitted by the executor of the decedent's estate in order to qualify for the deduction.

Imposes an excise tax on ESOP dispositions of employer securities for which an estate tax deduction was allowed. Sets forth the amount of tax applicable to relevant taxable events as follows: (1) 30 percent of the amount realized from any disposition of employer securities by an ESOP or eligible worker-owned cooperative within three years of the group's acquisition of qualified employer securities; (2) 30 percent of the amount realized from a disposition (not within three years after acquisition) that occurs before allocation of such securities to participants' accounts in cases when the proceeds are not allocated; or (3) 30 percent of the repayment amount in cases of a payment by an ESOP of any part of a loan used to acquire employer securities from transferred assets.

Sets out the ordering rules to govern dispositions of employer securities for purposes of this excise tax and another specified excise tax relating to ESOPs.

Makes the excise tax inapplicable to: (1) dispositions to employees, in certain cases; (2) exchanges associated with the liquidation of a corporation into a cooperative or with other reorganizational purposes; and (3) sales effected to meet IRC diversification requirements relating to pension trusts.

Places liability for the excise tax on the employer maintaining the ESOP or the eligible worker-owned cooperative.

Subtitle E: Provisions Relating to Excise Taxes and User Fees - Part I: Excise Taxes - Extends through December 31, 1990, the three percent excise tax on telephone service. (The tax is currently due to expire as of 1988.)

Amends the IRC with respect to the excise taxes on diesel fuel and aviation fuel to impose the tax on the sale of the taxable fuel by producers or importers, including wholesale distributors. (Under current law these taxes are generally imposed on the sale by a retailer to the ultimate consumer.) Repeals exemptions based on certain uses of the relevant fuels, but provides for refunds of tax paid with respect to fuels used for nontaxable purposes. Authorizes the Secretary of the Treasury to issue regulations to exempt specified types of sales from the tax.

Extends until January 1, 2014 (currently January 1, 1996), the potential termination date for the temporary increase in the coal excise tax rate. (An earlier termination date applies if certain solvency conditions are met with respect to the Black Lung Disability Trust Fund.)

Part II: Tax-Related User Fees - Directs the Secretary of the Treasury to establish a program requiring user fee payments in connection with requests to the Internal Revenue Service for ruling letters, opinion letters, determination letters, and for similar requests. Sets forth criteria to govern such fees.

Imposes an occupational tax of $1,000 per year on proprietors of: (1) distilled spirits plants; (2) bonded wine cellars; (3) bonded wine warehouses; and (4) taxpaid wine bottling houses. Reduces the rate to $500 per year for certain small proprietors.

Increases existing occupational taxes as follows: (1) for brewers, from $110 per year to $1,000 per year for each brewery, with a reduced rate of $500 per year for certain small proprietors; (2) for wholesale dealers in liquors, from $255 per year to $500 per year; (3) for wholesale dealers in beer, from $123 per year to $500 per year; (4) for retail dealers in liquors, from $54 per year to $250 per year; and (5) for retail dealers in beer, from $24 per year to $250 per year. Repeals the occupational tax on limited retail dealers of liquors, wine, or beer.

Replaces variable rates used with regard to nonbeverage domestic drawback claimants with a single rate of $500 per year.

Denies the validity of a permit for certain tax-free industrial uses of distilled spirits unless the holder pays a special tax of $250 with respect to the relevant site.

Imposes an occupational tax of $1,000 per year for each relevant premises on persons engaged in business as manufacturers of tobacco products, cigarette papers, and tubes, and on export warehouse proprietors. Applies a reduced rate of $500 per year for certain small proprietors. Fixes criminal penalties for willful failure to pay the tax.

Increases the occupational tax on importers and manufacturers of firearms from $500 per year to $1,000 per year and on dealers from $250 per year to $500 per year. Applies a reduced rate for small importers and manufacturers.

Subtitle F: Other Revenue Provisions - Part I: Targeted Jobs Credit - Amends the IRC to revise the definition of "wages" for purposes of determining the amount of the targeted jobs credit against income tax. Excludes from the wages applicable to such credit any amount paid by an employer to an employee for services that are the same as, or substantially similar to, those performed by employees participating in or affected by the strike or lockout during the period of such strike or lockout when such employee's principal place of employment is the affected plant or facility.

Part II: Treatment of Certain Illegal Irrigation Subsidies - Requires illegal Federal irrigation subsidies to be included in a taxpayer's gross income.

Part III: Compliance - Provides that State escheat laws shall not apply to refunds of Federal tax.

Expresses the sense of the Congress that: (1) the Congress should increase outlays to the IRS by specified amounts in FY 1989 and 1990 in the areas of taxpayer assistance and enforcement; (2) the IRS should offer improved taxpayer assistance and enforcement efforts by using these outlays in ways recommended in the Dorgan Task Force Report; (3) the Congress should undertake an experimental multiyear authorization and two-year appropriation for the IRS consistent with specified public law; and (4) increased funding should be provided for both research and the compilation and analysis of income.

Requires the IRS: (1) to issue a report by April 15, 1989, on the extent of the tax gap and possible measures to decrease it; and (2) to report annually on the improvements being made in the audit rate, taxpayer assistance, and enforcement efforts.

Part IV: Tax-Exempt Bond Provisions - Amends IRC provisions relating to taxable private activity bonds to include any bond issued as part of an issue if the amount of the proceeds to be used either directly or indirectly for the acquisition of nongovernmental output property exceeds the lesser of five percent or $5,000,000. Provides an exception for bonds in connection with property to be used to provide output in certain existing service areas and in the case of annexations meeting specified criteria.

Revises provisions governing tax-exempt bonds issued by Indian tribal governments to deny the tax exclusion of interest on bonds whose proceeds are used in the exercise of functions that are not customarily performed by State and local governments. Creates an exception to permit the issuance of tax-exempt bonds to finance certain tribal manufacturing facilities.

Subtitle G: Lobbying and Political Activities of Tax-Exempt Organizations - Part I: Disclosure Requirements - Requires tax-exempt organizations not eligible to receive tax-deductible charitable contributions to include in every written, broadcast, or telephone fundraising solicitation an express and conspicuous statement that gifts or contributions to the organization are not deductible as charitable contributions for Federal income tax purposes. Exempts from this requirement: (1) organizations having gross receipts of $100,000 or less; and (2) coordinated fundraising campaigns that solicit fewer than ten persons in a year. Fixes penalties for failure to comply with this disclosure requirement.

Provides for public inspection, at organization offices, of both the annual returns and the application for recognition of exemption filed by tax-exempt organizations. Protects from disclosure the names and addresses of contributors.

Requires that tax-exempt charitable entities (501(c)(3) organizations) provide annual information with respect to transfers and other transactions involving certain other tax-exempt organizations as the Secretary of the Treasury might require to prevent misallocation of revenues or expenses or any diversion of funds from the organization's exempt purpose.

Amends IRC penalty provisions relating to required filings by tax-exempt organizations and certain trusts to: (1) revise the maximum penalty applicable in certain cases; (2) fix a penalty for failure to include required and accurate information on a return; (3) fix a penalty for failure to comply with public inspection requirements; and (4) treat the penalties as tax for administrative purposes.

Assesses penalties against tax-exempt organizations that willfully fail to comply with public inspection requirements.

Imposes a penalty on any tax-exempt organization or political organization that offers to sell to an individual specific information or a routine service that could be readily obtained by that individual free of charge from a Federal agency.

Part II: Political Activities - Extends the prohibition against certain political activities by tax-exempt organizations to include activities in opposition to any candidate (current law includes only those activities on behalf of a candidate).

Provides that any 501(c)(3) organization whose status is terminated by reason of intervening in any political campaign either for or against a candidate for public office shall never be treated as a tax-exempt not-for-profit civic league or organization.

Imposes on a tax-exempt 501(c)(3) organization: (1) a ten percent excise tax on its political expenditures; and (2) a 100 percent tax on any such expenditure that has been subject to the ten percent penalty tax and has not been corrected within the taxable period.

Imposes on the manager of a 501(c)(3) organization: (1) a two and one-half percent tax, to a maximum amount of $5,000, if such manager knowingly agrees to a political expenditure by the organization; and (2) a 50 percent tax, to a maximum of $10,000, if the manager refuses to agree to part or all of a correction of the prohibited expenditure.

Identifies the types of expenditures considered to be political.

Provides for abatement or refund of any first tier (initial) excise tax on political expenditures if the affected organization establishes that the taxable event was due to reasonable cause and not to willful neglect and was corrected within the proper time.

Authorizes a civil action in U.S. district court in the name of the United States to enjoin a 501(c)(3) organization from making additional political expenditures and for other relief appropriate to ensure that the organization's assets are preserved for charitable purposes. Permits such an action only if: (1) the Internal Revenue Service has notified the organization of its intent to seek the injunction and (2) the Commissioner of Revenue has personally determined that the organization has flagrantly participated in prohibited campaign activity, and that injunctive relief is appropriate to prevent future political expenditures.

Directs the Secretary of the Treasury, upon the finding that a 501(c)(3) organization has made political contributions in flagrant violation of the prohibition against such expenditures, to make an immediate termination assessment of any income tax payable by such organization, as well as any penalty taxes due with respect to political expenditures. Sets forth guidelines to govern such termination assessments.

Imposes: (1) a five percent excise tax, to be paid by the organization, on the lobbying expenses of any organization whose 501(c)(3) status has been lost because of such expenditures; and (2) a corresponding penalty tax to be paid by the organization manager who agreed to such expenditures, knowing that they could result in the organization's loss of tax-exempt status.